Cross-Country Differences in Household Healthcare Spending

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ID: 327501
2026
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Abstract
Abstract Introduction Health systems face financial pressures as populations age and economic growth slows, with implications for who pays for health care and for what drives expenditure growth. Methods We examined changes in outpatient and pharmaceutical care financing across OECD countries from 2000 to 2023. Results While overall health spending growth slowed across countries after the Great Recession, household spending grew modestly everywhere, averaging about half a percentage point growth annually. The United States stood out for persistently high out-of-pocket financing burden—over twice that of most peer countries—and for price growth, rather than utilization, driving out-of-pocket spending for pharmaceutical care. Other countries saw out-of-pocket spending driven more by volume growth and slower price growth. Conclusion These patterns highlight potential affordability pressures from out-of-pocket healthcare payments, particularly in the U.S.. Policymakers should regularly monitor financial hardship from out-of-pocket payments and reconsider using cost-sharing to address health financing sustainability challenges.
Reference Key
openalex_W7207774709 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Irene Papanicolas, Jonathan Cylus, Maecey Niksch, Luca Lorenzoni
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Journal Health Affairs Scholar
Year 2026
DOI
10.1093/haschl/qxag234
URL
https://doi.org/10.1093/haschl/qxag234
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