Higher prices and greater use of technology appear to be the main factors driving the high rates of spending in the United States, rather than greater use of physician and hospital services, according to a Commonwealth Fund report that presents analysis of prices and health care spending in 13 industrialized countries.
In 2009, there were 2.4 physicians per 100,000 people in the US, fewer than in all the countries in the study except Japan. The US also had the fewest physician consultations (3.9 per capita) of any country except Sweden. Relative to the other countries in the study, the US also had fewer hospital beds, short lengths of stay for acute care, and fewer hospital discharges per 1,000 population. On the other hand, US hospital stays were far more expensive than those in other countries—more than $18,000 per discharge. By comparison, the cost per discharge in Canada was about $13,000, while in Sweden, Australia, New Zealand, France, and Germany it was less than $10,000.
High spending in the United States does not always translate into high-quality care, says the report. The US had the highest survival rates in the study for breast cancer and the best survival rates, along with Norway, for colorectal cancer. However, cervical cancer survival rates in the US were worse than average and well below those of Norway. Compared with other countries in the study, the US had high rates of asthma-related deaths among people ages 5 to 39 and, along with Germany, very high rates of amputations resulting from diabetes. US rates of in-hospital deaths after heart attack and stroke were average.
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