Households are directly responsible for funding
a fifth of all health spending across the OECD
Figure 1. One in every five health dollars is paid out-of-pocket by households across the OECD
0
500
1000
1500
2000
2500
0
10
20
30
40
50
% of health spending Per capita (USD PPP)
1. Data refer to 2015. Source: OECD Health Statistics 2018 (Data refer to 2016).
Pharmaceuticals and dental services account for
over half of household payments on healthcare
Households fund two-thirds of spending
on dental care and medical devices
Figure 2. Households finance a large proportion of spending on dental care and medical goods
Out-of-pocket spending as a share of health spending by function of care (%)
23%
12%
21%
22%
NA
24%
29%
34%
33%
NA
6%
NA
47%
34%
NA
NA
NA
14%
33%
48%
NA
12%
NA
NA
NA
46%
30%
NA
29%
2%
11%
28%
31%
NA
NA
14%
25%
PrescribedMedicines
58%
52%
58%
38%
NA
53%
68%
74%
68%
NA
25%
100%
76%
74%
NA
NA
NA
22%
68%
93%
82%
40%
90%
22%
NA
72%
71%
NA
36%
20%
98%
61%
78%
NA
NA
40%
61%
Dental care
3%
24%
6%
18%
NA
0%
8%
36%
18%
22%
24%
NA
15%
NA
14%
NA
23%
7%
28%
13%
4%
19%
NA
8%
NA
9%
0%
25%
1%
3%
16%
7%
34%
NA
30%
27%
15%
Long-term care
13%
19%
20%
6%
NA
10%
7%
15%
12%
0%
9%
32%
39%
20%
NA
NA
NA
15%
31%
45%
24%
10%
14%
7%
NA
15%
17%
NA
5%
14%
12%
14%
34%
NA
NA
NA
18%
Outpatientcare
5%
4%
13%
2%
NA
4%
7%
1%
5%
2%
2%
26%
8%
1%
2%
NA
3%
2%
20%
17%
6%
2%
21%
9%
NA
1%
2%
11%
10%
2%
2%
1%
5%
NA
1%
NA
6%
AustraliaAustria
BelgiumCanada
ChileCzech Republic
DenmarkEstoniaFinlandFrance
GermanyGreece
HungaryIcelandIreland
IsraelItaly
JapanKoreaLatvia
LithuaniaLuxembourg
MexicoNetherlands
New ZealandNorwayPoland
PortugalSlovak Republic
SloveniaSpain
SwedenSwitzerland
TurkeyUnited Kingdom
United StatesOECD
Inpatient care
100%
98%
100%
100%
NA
100%
88%
98%
100%
NA
98%
NA
NA
92%
NA
NA
NA
100%
83%
100%
NA
NA
100%
NA
NA
NA
99%
NA
NA
100%
100%
100%
66%
NA
NA
97%
96%
Over-the-counter Medicines
64%
56%
57%
61%
NA
62%
51%
70%
99%
16%
44%
8%
30%
9%
80%
NA
75%
68%
96%
90%
78%
43%
91%
47%
NA
59%
55%
66%
59%
63%
94%
60%
48%
NA
77%
49%
60%
Therapeutic appliances
Source: OECD Health Statistics 2018 (Data refer to 2016).
High levels of out-of-pocket payments can
impact on individuals’ access to care
Reliance on OOP payments can undermine the
ability to ensure financial protection
Figure 3. The level of out of pocket spending can give some hint of the incidence of catastrophic spending
AUT
CZE
EST
FRADEU
GRC
HUN
IRL
LVA
LTU
POLPRT
SVK
SVN
SWEGBR
0%
5%
10%
15%
5% 15% 25% 35%
Sha
re o
f hou
seho
lds
with
cat
astro
phic
spe
ndin
g on
hea
lth
OOP spending as share of all health spending (excl. LTC)
Note: The y-axis refers to the share of households with out-of-pocket payments that are greater than 40% of household capacity to pay for health care, which is taken as household consumption minus a standard amount to cover basic needs (food, housing and utilities). Source: OECD Health Statistics 2018 and WHO Regional Office for Europe (2018).
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