What does this research mean for the field?

Between 2000 and 2023, household healthcare spending grew modestly across OECD countries, with the United States experiencing a significantly higher out-of-pocket burden driven primarily by price growth rather than utilization. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To analyze changes and underlying drivers of outpatient and pharmaceutical care financing across OECD nations from 2000 to 2023.

September 5, 2026Health Affairs ScholarOpen Access

Cross-Country Differences in Household Healthcare Spending

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Authors

IPIrene PapanicolasRhode Island Department of Health JCJonathan CylusEuropean Observatory on Health Systems and Policies MNMaecey NikschProvidence College

Discussion

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Implication

Cross-national comparative analysis reveals elevated household healthcare spending in the United States, highlighting acute affordability burdens driven by pharmaceutical price growth.

Key Points

To analyze changes and underlying drivers of outpatient and pharmaceutical care financing across OECD nations from 2000 to 2023.
Analyzed outpatient and pharmaceutical financing trends across OECD member countries between 2000 and 2023.
Assessed the differential impacts of service utilization versus price inflation on household out-of-pocket spending.
Household health spending expanded across OECD countries by an average of approximately 0.5 percentage points annually after the Great Recession.
The United States maintained an out-of-pocket financing burden exceeding twice that of peer nations, primarily propelled by pharmaceutical price inflation rather than utilization.
Other OECD nations experienced out-of-pocket cost growth driven predominantly by increased service volume alongside slower price growth.

Cite This Study

Papanicolas et al. (2026) studied this question.

synapsesocial.com/papers/6a9bd4606b95aff0620ec04e https://doi.org/10.1093/haschl/qxag234

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September 5, 2026Health Affairs ScholarOpen Access

Cross-Country Differences in Household Healthcare Spending

View Full Paper

Ask AI

Bookmark

Authors

IPIrene PapanicolasRhode Island Department of Health JCJonathan CylusEuropean Observatory on Health Systems and Policies MNMaecey NikschProvidence College

Discussion

Member takes

Implication

Cross-national comparative analysis reveals elevated household healthcare spending in the United States, highlighting acute affordability burdens driven by pharmaceutical price growth.

Key Points

To analyze changes and underlying drivers of outpatient and pharmaceutical care financing across OECD nations from 2000 to 2023.
Analyzed outpatient and pharmaceutical financing trends across OECD member countries between 2000 and 2023.
Assessed the differential impacts of service utilization versus price inflation on household out-of-pocket spending.
Household health spending expanded across OECD countries by an average of approximately 0.5 percentage points annually after the Great Recession.
The United States maintained an out-of-pocket financing burden exceeding twice that of peer nations, primarily propelled by pharmaceutical price inflation rather than utilization.
Other OECD nations experienced out-of-pocket cost growth driven predominantly by increased service volume alongside slower price growth.

Cite This Study

Papanicolas et al. (2026) studied this question.

synapsesocial.com/papers/6a9bd4606b95aff0620ec04e https://doi.org/10.1093/haschl/qxag234

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