US and Developed Countries: Comparing Health Care Systems - 2012 . Steven Miles, MD University of Minnesota. Efficiency: Outcomes for $. How does the US stack up?. $/person-yr (adjusted for purchasing power parity).
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Steven Miles, MD
University of Minnesota
How does the US stack up?
The Organization for Economic Cooperation and Development was founded in 1961 to compile statistics and policy reports to promote economic growth.
OECD 2012 (2009 data)
USA has highest rates
of preventable death
and smallest decreases
in preventable deaths
We are falling further behind!
<75 yo. Amen Mort is deaths preventable by HC system, e.g. CA, CVD, DM, inf, etc. Rates are /100,000
Health Aff 2008;58-71. (See also Health Aff 2012;31:2114-22.
If rationing Improves outcomes, is health care toxic?
We do more but we do not have lower heart attack mortality.
Less dialysis and transplantation looks like rationing
US v Norway have same incidence of early kidney disease but disease going to kidney failure reflects better routine health care.
J Am Soc Nephrol 2006;17:2275-84.
OECD Health at a Glance: 2011
OECD 2012 Compiled by Commonwealth
Per pers $
Hip Replacement /100,000
OECD 2011: Compiled by Commonwealth
The American Consumer is too:
Over financed Armed with Lawyers
United Nations: 2011data
Per Capita Health Spending and % Elderly: Really Old!
A young US uniquely out of position to deal with an aging population.
% of population over 65
OECD 2012, US Census Dept
Obese % Adults BMI > 30 Kg/M2 e.g. 5’9” 200+ pounds
Health care costs increase for people with BMI > 35 (237 lbs) and most of this occurs late in life (US is a young country). Obesity accounts for 2-4% of our excess costs relative to other developed countries. Health Affairs 2003;(May).
Note: Our gov expenditures are comparable to other nations!
(or, How can we do better?)
Lower Inequality associated with:
Soc Sci & Med 2008;66:1719-32.
High Primary Care Associated with Lower Personally Pay for Health CareHealth Care Costs
USAPrimary Care Orientation
Low 10 care orient
Per person costs/yr
Note: data is not updated
Health Policy 2002;60:201-18.
Health Aff 2007;10. w7171-34.
2008 Commonwealth Fund International Health Policy Survey of Sicker Adults.