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U.S. Ranks Near Bottom in Efficiency of Healthcare Spending

A new study by UCLA researchers and colleagues in Canada reveals that the United States healthcare system ranks 22nd out of 27 high-income nations when analyzed for its efficiency of turning dollars spent into extending lives.

The study illuminates stark differences in countries’ efficiency of spending on healthcare, and the U.S.’s inferior ranking reflects a high price paid and a low return on investment.

  U.S. Ranks Near Bottom in Efficiency of Healthcare Spending

For example, every additional $100 spent on healthcare by the United States translated into a gain of less than half-a-month of life expectancy. In Germany, every additional $100 spent translated into more than four months of increased life expectancy.

The researchers also discovered significant gender disparities within countries. “Out of the 27 high-income nations we studied, the United States ranks 25th when it comes to reducing women’s deaths,” says Jody Heymann, PhD, senior author and dean of UCLA’s Jonathan and Karin Fielding School of Public Health. “The country’s efficiency of investments in reducing men’s deaths is only slightly better, ranking 18th.”

The study, which utilized data from 27 member countries of the Organization for Economic Cooperation and Development collected over 17 years (1991–2007), is the first known research to estimate health-spending efficiency by gender across industrialized nations.

The report’s findings bring to light several questions. How is it possible for the United States to have one of the most advanced economies yet one of the most inefficient healthcare systems? And while the U.S. healthcare system is performing so poorly for men, why is it performing even worse for women? The exact causes of the gender gap are unknown, the researchers say, thus highlighting the need for additional research on the topic, but the nation’s lack of investment in prevention for both men and women warrants attention. “The most effective way to stop people from dying prematurely is to prevent them from getting sick in the first place,” Dr. Heymann says.

“Analyzing Whether Countries Are Equally Efficient at Improving Longevity for Men and Women,” American Journal of Public Health, December 12, 2013


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