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Report: U.S. ranks poorly in efficiency of healthcare spending

Sunday December 15, 2013
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The U.S. healthcare system ranks 22nd out of 27 high-income nations in an analysis of nations’ efficiency at turning money spent into extending lives.

The study, published online Dec. 12 in the “First Look” section of the American Journal of Public Health, illuminates stark differences in countries’ efficiency of spending on healthcare. The low ranking of the U.S. reflects a high price paid and a low return on investment, reported researchers with the UCLA Fielding School of Public Health and McGill University in Montreal.

For example, every additional hundred dollars spent on healthcare by the U.S. translated into a gain of less than a half-month of life expectancy during the study period. In Germany, every additional hundred dollars 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 death,” Jody Heymann, MD, PhD, senior author of the study and dean of the UCLA Fielding School of Public Health, said in a news release. “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 described as the first known research to estimate health-spending efficiency by gender across industrialized nations.

The exact causes of the gender gap in the U.S. are unknown, the researchers said, 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,” Heymann said.

Last year, the U.S. spent a tiny fraction of its $2.65 trillion annual healthcare budget on prevention, according to the news release. Healthcare spending is a large — and ever-increasing — portion of government budgets, particularly in the U.S. Therefore, allocating the necessary resources for prevention and improving overall efficiency are both critically important to preventing premature deaths and wiser spending, the researchers stressed.

Study: http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2013.301494

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