Life expectancy in the U.S. was the lowest, at 78.8 years, the study also found. In the other countries, life expectancy ranged from 80.7 to 83.9 years.
Infant mortality rates were highest in the U.S., with 5.8 fatalities out of every 1,000 live births. For other countries, the average infant mortality rate was 3.6 fatalities for every 1,000 live births.
Some individual U.S. states, however, have outcomes on par with other high-income countries. For example, life expectancy in Hawaii, Minnesota and Connecticut were similar to other high-income countries, while life expectancy was much worse in such states as Mississippi.
Inequalities in innovation, costs and outcomes may be reasons the U.S. lags behind other high-income countries, Stephen Parente of the University of Minnesota writes in an accompanying editorial.
“Although some states and regions throughout the U.S. serve as excellent laboratories for best practices, these parts of the U.S. system need to be shared with greater equity so that underperforming U.S. regions can and will demand better care,” Parente writes.
One limitation of the study is that researchers lacked information on the quality of care across all of the countries.
“It is quite challenging to disentangle the share of international differences in spending driven by differences in the quantity of care used and differences in the prices paid for that care, given how difficult it is to measure quality and intensity of care,” Katherine Baicker, author of a separate editorial and dean of the Harris School of Public Policy at the University of Chicago, said by email.²
References
- Papanicolas I, Woskie LR, Jha AK. Healthcare spending in the United States and other high-income countries. JAMA. 2018 Mar 13;319(10):1024-1039. doi: 10.1001/jama.2018.1150.
- Baicker K, Chandra A. Challenges in understanding differences in healthcare spending between the United States and other high-income countries. JAMA. 2018 Mar 13;319(10):986-987. doi: 10.1001/jama.2018.1152.
