In Search of Value: An International Comparison of Cost, Access, and Outcomes

Health Affairs

Volumn 16, Issue 6, 1997, Pages 163-171

  Anderson, Gerard F ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGED; ARTICLE; COMPARATIVE STUDY; DEVELOPED COUNTRY; FEMALE; HEALTH CARE COST; HEALTH CARE DELIVERY; HEALTH CARE QUALITY; HEALTH SURVEY; HUMAN; MALE; NEWBORN; STATISTICS; UNITED STATES; VITAL STATISTICS;

ADULT; AGED; DEVELOPED COUNTRIES; FEMALE; HEALTH EXPENDITURES; HEALTH SERVICES ACCESSIBILITY; HEALTH STATUS INDICATORS; HUMANS; INFANT, NEWBORN; MALE; QUALITY OF HEALTH CARE; UNITED STATES; VITAL STATISTICS;

EID: 0347873669     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.16.6.163     Document Type: Article

References (33)

1. Organization for Economic Cooperation and Development, OECD Health Data, 1997 (Washington: OECD, 1997).
2. G.J. Scheiber, J.P. Poullier, and L.M. Greenwald, "Health System Performance in OECD Countries, 1980-1992," Health Affairs (Fall 1994): 100-112; G.J. Scheiber, J.P. Poullier, and L.M. Greenwald, "Health Spending, Delivery, and Outcomes in OECD Countries," Health Affairs (Summer 1993): 120-129; D.A. Rublee and M. Schneider, "International Health Spending: Comparisons with the OECD," Health Affairs (Fall 1991): 187-198; and OECD, New Directions in Health Care Policy, Health Policy Studies No. 7 (Paris: OECD, 1995). This latter publication provides a good overview of the methodological issues involved in constructing the data set.
3. G.J. Scheiber, J.P. Poullier, and L.M. Greenwald, "Health System Performance in OECD Countries, 1980-1992," Health Affairs (Fall 1994): 100-112; G.J. Scheiber, J.P. Poullier, and L.M. Greenwald, "Health Spending, Delivery, and Outcomes in OECD Countries," Health Affairs (Summer 1993): 120-129; D.A. Rublee and M. Schneider, "International Health Spending: Comparisons with the OECD," Health Affairs (Fall 1991): 187-198; and OECD, New Directions in Health Care Policy, Health Policy Studies No. 7 (Paris: OECD, 1995). This latter publication provides a good overview of the methodological issues involved in constructing the data set.
4. G.J. Scheiber, J.P. Poullier, and L.M. Greenwald, "Health System Performance in OECD Countries, 1980-1992," Health Affairs (Fall 1994): 100-112; G.J. Scheiber, J.P. Poullier, and L.M. Greenwald, "Health Spending, Delivery, and Outcomes in OECD Countries," Health Affairs (Summer 1993): 120-129; D.A. Rublee and M. Schneider, "International Health Spending: Comparisons with the OECD," Health Affairs (Fall 1991): 187-198; and OECD, New Directions in Health Care Policy, Health Policy Studies No. 7 (Paris: OECD, 1995). This latter publication provides a good overview of the methodological issues involved in constructing the data set.
5. G.J. Scheiber, J.P. Poullier, and L.M. Greenwald, "Health System Performance in OECD Countries, 1980-1992," Health Affairs (Fall 1994): 100-112; G.J. Scheiber, J.P. Poullier, and L.M. Greenwald, "Health Spending, Delivery, and Outcomes in OECD Countries," Health Affairs (Summer 1993): 120-129; D.A. Rublee and M. Schneider, "International Health Spending: Comparisons with the OECD," Health Affairs (Fall 1991): 187-198; and OECD, New Directions in Health Care Policy, Health Policy Studies No. 7 (Paris: OECD, 1995). This latter publication provides a good overview of the methodological issues involved in constructing the data set.
6. For certain variables, not all twenty-nine countries responded to the OECD questionnaire. For these variables, the data set was restricted to members of the G7 for some analyses.
7. For Switzerland, the most recent figure available is from 1995.
8. Purchasing power parities express the rate at which one currency should be converted into another for a given expenditure to purchase the same set of goods and services in both countries. Purchasing power parities are generally considered to be a better way to convert money into a common exchange than other adjustments such as exchange rates, but they are not specific to health care.
9. As measured by the average annual growth rate in percentage of GDP spent on health care.
10. A lack of data prevents a comparison adjusting for GDP price deflators. However, the data are adjusted for purchasing power parities. Ulf G. Gerdtham and Bengt Jönsson found similar results using purchasing power parities and GDP price deflators. U.G. Gerdtham and B. Jönsson, "Conversion Factor Instability in International Comparisons of Health Care Expenditures," Journal of Health Economics 10, no. 2 (1991): 227-234.
11. Luxembourg, Korea, Japan, and the Czech Republic had higher rates of increase than the United States during 1990-1995. They did not report data for 1996.
12. J.P. Newhouse, "An Iconoclastic View of Health Cost Containment," Health Affairs (Supplement 1993): 152-171. See also E.A. Peden and M.S. Freeland, "A Historical Analysis of Medical Spending Growth, 1960-1993," Health Affairs (Summer 1995): 235-247. The authors show that half of the growth in U.S. health care spending between 1960 and 1993 can be attributed to the expansion of health insurance coverage.
13. J.P. Newhouse, "An Iconoclastic View of Health Cost Containment," Health Affairs (Supplement 1993): 152-171. See also E.A. Peden and M.S. Freeland, "A Historical Analysis of Medical Spending Growth, 1960-1993," Health Affairs (Summer 1995): 235-247. The authors show that half of the growth in U.S. health care spending between 1960 and 1993 can be attributed to the expansion of health insurance coverage.
14. This is not the measure that U.S. policymakers and researchers are accustomed to using to evaluate insurance coverage. However, the percentage of the population covered by all forms of health insurance is not available in the OECD data.
15. J.K. Iglehart, "Health Policy Report: Germany's Health Care System (Part 1)," The New England Journal of Medicine 324, no. 7 (1991): 503-508; and J.K. Iglehart, "Health Policy Report: Germany's Health Care System (Part 2)," The New England Journal of Medicine 324, no. 24 (1991): 1750-1756.
16. J.K. Iglehart, "Health Policy Report: Germany's Health Care System (Part 1)," The New England Journal of Medicine 324, no. 7 (1991): 503-508; and J.K. Iglehart, "Health Policy Report: Germany's Health Care System (Part 2)," The New England Journal of Medicine 324, no. 24 (1991): 1750-1756.
17. Based on the March Current Population Survey point-in-time estimate. Data obtained directly from Housing and Household Economic Statistics Division, U.S. Bureau of the Census, 1997.
18. W. Glaser, Health Insurance in Practice: International Variations in Financing, Benefits, and Problems (San Francisco: Jossey-Bass, 1991).
19. D. Parkin, A. McGuire, and B. Yule, "Aggregate Health Care Expenditures and National Income: Is Health Care a Luxury Good?" Journal of Health Economics 6, no. 2 (1987): 109-127; M. Pfaff, "Differences in Health Care Spending across Countries: Statistical Evidence," Journal of Health Politics, Policy and Law (Spring 1990): 1-25; U.G. Gerdtham, "Pooling International Health Expenditure Data," Health Economics 1, no. 4 (1992): 217-231; and J.M. O'Connell, "The Relationship between Health Expenditures and the Age Structure of the Population in OECD Countries," Health Economics 5, no. 6 (1996): 573-578.
20. D. Parkin, A. McGuire, and B. Yule, "Aggregate Health Care Expenditures and National Income: Is Health Care a Luxury Good?" Journal of Health Economics 6, no. 2 (1987): 109-127; M. Pfaff, "Differences in Health Care Spending across Countries: Statistical Evidence," Journal of Health Politics, Policy and Law (Spring 1990): 1-25; U.G. Gerdtham, "Pooling International Health Expenditure Data," Health Economics 1, no. 4 (1992): 217-231; and J.M. O'Connell, "The Relationship between Health Expenditures and the Age Structure of the Population in OECD Countries," Health Economics 5, no. 6 (1996): 573-578.
21. D. Parkin, A. McGuire, and B. Yule, "Aggregate Health Care Expenditures and National Income: Is Health Care a Luxury Good?" Journal of Health Economics 6, no. 2 (1987): 109-127; M. Pfaff, "Differences in Health Care Spending across Countries: Statistical Evidence," Journal of Health Politics, Policy and Law (Spring 1990): 1-25; U.G. Gerdtham, "Pooling International Health Expenditure Data," Health Economics 1, no. 4 (1992): 217-231; and J.M. O'Connell, "The Relationship between Health Expenditures and the Age Structure of the Population in OECD Countries," Health Economics 5, no. 6 (1996): 573-578.
22. D. Parkin, A. McGuire, and B. Yule, "Aggregate Health Care Expenditures and National Income: Is Health Care a Luxury Good?" Journal of Health Economics 6, no. 2 (1987): 109-127; M. Pfaff, "Differences in Health Care Spending across Countries: Statistical Evidence," Journal of Health Politics, Policy and Law (Spring 1990): 1-25; U.G. Gerdtham, "Pooling International Health Expenditure Data," Health Economics 1, no. 4 (1992): 217-231; and J.M. O'Connell, "The Relationship between Health Expenditures and the Age Structure of the Population in OECD Countries," Health Economics 5, no. 6 (1996): 573-578.
23. Peden and Freeland, "A Historical Analysis of Medical Spending Growth, 1960-1993."
24. P. Lazaro and K. Fitch, "The Distribution of 'Big Ticket' Technologies in OECD Countries," Medical International Journal of Technology Assessment in Health Care 11, no. 3 (1995): 552-570.
25. For a description of the Japanese health care system, see N. Ikegami and J.C. Campbell, "Medical Care in Japan," The New England Journal of Medicine 333, no. 19 (1995): 1295-1299.
26. The OECD recognizes this issue and is attempting to modify the data.
27. The other G7 countries spend less on hospital care and an equivalent or lower percentage of their total health care expenditures on hospital care.
28. Per capita spending on pharmaceuticals (adjusted for purchasing power parities) in 1995 was $307 in the United States, $198 in the United Kingdom, $260 in Italy, $267 in Germany, $276 in Canada, $328 in France, and $308 in Japan in 1994.
29. How the OECD calculates the value for the United States is unclear since a smaller percentage of the population is insured by Medicare, Medicaid, and other public programs.
30. Iglehart, "Health Policy Report: Germany's Health Care System (Parts 1 and 2)."
31. F.T. Schut, "Health Care Reform in the Netherlands: Balancing Corporatism, Etatism, and Market Mechanisms," Journal of Health Politics, Policy and Law (Fall 1995): 615-652.
32. Italy does not report these data to the OECD.
33. Ikegami and Campbell, "Medical Care in Japan."