In 2022, U.S. out-of-pocket health care payments was reported to come to an average of ******* U.S. dollars per capita. In the U.S., especially out-of-pocket payments for prescribed drugs can be very high. This statistic depicts the per capita out-of-pocket health care payments in the United States from 1970 to 2022.

The United States has the highest expenditure on health care per capita globally. However, the U.S. has an unique way of paying for their health care where a majority of the expenditure falls upon private insurances. In FY 2024, around one ***** of all health expenditure is paid by private insurance. Public insurance programs Medicare and Medicaid accounted for ** and ** percent, respectively, of health expenditure during that same year. U.S. health care system Globally health spending has been increasing among most countries. However, the U.S. has the highest public and private per capita health expenditure among all countries globally, followed by Switzerland. As of 2020, annual health care costs per capita in the United States totaled to over ** thousand U.S. dollars, a significant amount considering the average U.S. personal income is around ** thousand dollars. Out of pocket costs in the U.S. Aside from overall high health care costs for U.S. residents, the total out-of-pocket costs for health care have been on the rise. In recent years, the average per capita out-of-pocket health care payments have exceeded *** thousand dollars. Physician services, dental services and prescription drugs account for the largest proportion of out-of-pocket expenditures for U.S. residents.

United States US: Proportion of Population Spending More Than 25% of Household Consumption or Income on Out-of-Pocket Health Care Expenditure: % data was reported at 0.781 % in 2013. This records a decrease from the previous number of 0.856 % for 2012. United States US: Proportion of Population Spending More Than 25% of Household Consumption or Income on Out-of-Pocket Health Care Expenditure: % data is updated yearly, averaging 0.880 % from Dec 1995 (Median) to 2013, with 18 observations. The data reached an all-time high of 1.078 % in 2000 and a record low of 0.724 % in 2008. United States US: Proportion of Population Spending More Than 25% of Household Consumption or Income on Out-of-Pocket Health Care Expenditure: % data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s USA – Table US.World Bank: Poverty. Proportion of population spending more than 25% of household consumption or income on out-of-pocket health care expenditure, expressed as a percentage of a total population of a country; ; Wagstaff et al. Progress on catastrophic health spending: results for 133 countries. A retrospective observational study, Lancet Global Health 2017.; Weighted Average;

In 2020, the average out-of-pocket (OOP) spending on healthcare services per person in the U.S. for women amounted to ***** U.S. dollars, and for men, was ***** U.S. dollars. During the provided time interval, women on average spend approximately ************* U.S. dollars more than men OOP annually on healthcare services.

Household out-of-pocket payment’ means a direct payment for healthcare goods and services from the household primary income or savings, where the payment is made by the user at the time of the purchase of goods or the use of the services. Data are collected according to Commission Regulation (EC) 2015/359 as regards statistics on healthcare expenditure and financing (System of Health Accounts 2011 manual).

In the United States, average employee premium contributions and deductibles as a percentage of median household income have risen in the past decade. In 2020, an employee’s total potential out-of-pocket medical costs (premium and deductible) amounted to 11.6 percent of median income. This included 6.9 percent in employee premium contributions and 4.7 percent in deductibles. However, states varied greatly in median income spent on premiums and deductibles, with workers in Mississippi having to spend on average 19 percent of their income on potential out-of-pocket medical costs.

Employer sponsored health insurance In 2020, over half of the U.S. population has some type of employment-based health insurance coverage. The Affordable Care Act penalizes large employers (with 50 or more full-time employees), if they do not provide health insurance to their employees. Nevertheless, of the uninsured aged under 65 years, the large majority worked either full or part-time (or someone in their household did).

Out-of-pocket medical costs Despite having insurance coverage, most plans have a deductible, the amount an insured must pay themselves that year before their insurance starts covering for them. The average annual deductible for single coverage amounted to roughly 1,700 U.S. dollars in 2021. Even after reaching their deductible, most insured have other forms of out-of-pocket health costs in the form of co-payments and co-insurance for health services or prescription drugs.

This dataset contains data for the Healthcare Payments Data (HPD): Medical Out-of-Pocket Costs and Chronic Conditions report. The data covers three measurement categories: annual member count, annual median out-of-pocket count, annual median claim count. The annual member count quantify the number of unique individuals who received at least one medical service in the reporting year. Annual median out-of-pocket measurements quantifies the sum of copay, coinsurance, and deductible incurred by members. Annual median claim count measurements quantifies the number of distinct claims or encounters associated with members. Both 25th and 75th percentiles for out-of-pocket cost and claim count are also included. Measures are grouped by payer types, chronic conditions flag, chronic condition types, and chronic condition numbers.

United States US: Number of People Pushed Below the 50% Median Consumption Poverty Line by Out-of-Pocket Health Care Expenditure data was reported at 1,848,000.000 Person in 2013. This records a decrease from the previous number of 1,986,000.000 Person for 2012. United States US: Number of People Pushed Below the 50% Median Consumption Poverty Line by Out-of-Pocket Health Care Expenditure data is updated yearly, averaging 2,141,000.000 Person from Dec 1995 (Median) to 2013, with 18 observations. The data reached an all-time high of 3,810,000.000 Person in 1996 and a record low of 1,604,000.000 Person in 2011. United States US: Number of People Pushed Below the 50% Median Consumption Poverty Line by Out-of-Pocket Health Care Expenditure data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s USA – Table US.World Bank: Poverty. Number of people pushed below the 50% median consumption poverty line by out-of-pocket health care expenditure; ; Wagstaff et al. Progress on Impoverishing Health Spending: Results for 122 Countries. A Retrospective Observational Study, Lancet Global Health 2017; Sum;

In 2024, the out-of-pocket health care payments in Canada were projected to come to an average of approximately ***** Canadian dollars per capita, an increase from the previous year. This statistic depicts the per capita out-of-pocket health care payments in Canada from 2010 to 2024.

United Arab Emirates AE: Proportion of Population Spending More Than 10% of Household Consumption or Income on Out-of-Pocket Health Care Expenditure: % data was reported at 0.440 % in 2019. United Arab Emirates AE: Proportion of Population Spending More Than 10% of Household Consumption or Income on Out-of-Pocket Health Care Expenditure: % data is updated yearly, averaging 0.440 % from Dec 2019 (Median) to 2019, with 1 observations. The data reached an all-time high of 0.440 % in 2019 and a record low of 0.440 % in 2019. United Arab Emirates AE: Proportion of Population Spending More Than 10% of Household Consumption or Income on Out-of-Pocket Health Care Expenditure: % data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s United Arab Emirates – Table AE.World Bank.WDI: Social: Poverty and Inequality. Proportion of population spending more than 10% of household consumption or income on out-of-pocket health care expenditure. Out-of-pocket health expenditure is defined as any spending incurred by a household when any member uses a health good or service to receive any type of care (preventive, curative, rehabilitative, long-term or palliative care); provided by any type of provider; for any type of disease, illness or health condition; in any type of setting (outpatient, inpatient, at home).;Global Health Observatory. Geneva: World Health Organization; 2023. (https://www.who.int/data/gho/data/themes/topics/financial-protection);Weighted average;This is the Sustainable Development Goal indicator 3.8.2[https://unstats.un.org/sdgs/metadata/].

This data includes the top 25 list for costliest prescribed drugs, most frequently prescribed drugs and the prescribed drugs with the highest monthly median out-of-pocket cost for members. Each of these top 25 lists are broken out by payer type (i.e., All Payers, All Payers W/O Medi-Cal, Commercial, Medicare or Medi-Cal) and drug category (i.e., All, Brand, Generic, Biosimilar or Biologic). The includes National Drug Code (NDC), Year, Top 25 Ranking, National Drug Code, Drug Name, number of prescriptions, number of individuals, total costs, average cost per unit, average dispensed units per fill, drug unit of measure, monthly median out-of-pocket cost, 25th percentile for monthly out-of-pocket cost, 75th percentile for monthly out-of-pocket cost, and percent of monthly out-of-pocket cost with zero dollar amounts for each NDC in each top 25 list.

Haiti HT: Proportion of Population Spending More Than 25% of Household Consumption or Income on Out-of-Pocket Health Care Expenditure: % data was reported at 3.984 % in 2013. This records an increase from the previous number of 1.827 % for 2012. Haiti HT: Proportion of Population Spending More Than 25% of Household Consumption or Income on Out-of-Pocket Health Care Expenditure: % data is updated yearly, averaging 2.906 % from Dec 2012 (Median) to 2013, with 2 observations. The data reached an all-time high of 3.984 % in 2013 and a record low of 1.827 % in 2012. Haiti HT: Proportion of Population Spending More Than 25% of Household Consumption or Income on Out-of-Pocket Health Care Expenditure: % data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Haiti – Table HT.World Bank.WDI: Poverty. Proportion of population spending more than 25% of household consumption or income on out-of-pocket health care expenditure.; ; World Health Organization and World Bank. 2019. Global Monitoring Report on Financial Protection in Health 2019.; Weighted average;

IntroductionThis study aims to determine the out-of-pocket health expenditures of households in Turkey where individuals with rare diseases are residing.MethodsThe research population consisted registered members of associations who are members of the Rare Diseases Network. In addition to the general analysis including all participants, expenditures based on characteristics of disease holders were also calculated.ResultsA total of 439 participants were included in the analysis. We determined that special nutrition was the highest expenditure group and emergency departments were the lowest expenditure group. When all the participants were evaluated, the average cost of rare diseases was found to be Ł22,743 (€2,877). A significant relationship was found between income status and out-of-pocket health expenditures (p = 0.012).DiscussionPolicy makers should consider inclusion of special nutritional products and medical/non-medical devices used in treatment of rare diseases within the scope of reimbursement and the development of orphan drug legislation as the first actions to be taken.

Burkina Faso BF: Number of People Pushed Below the 50% Median Consumption Poverty Line by Out-of-Pocket Health Care Expenditure data was reported at 128,000.000 Person in 2009. This records a decrease from the previous number of 135,000.000 Person for 2003. Burkina Faso BF: Number of People Pushed Below the 50% Median Consumption Poverty Line by Out-of-Pocket Health Care Expenditure data is updated yearly, averaging 135,000.000 Person from Dec 1998 (Median) to 2009, with 3 observations. The data reached an all-time high of 136,000.000 Person in 1998 and a record low of 128,000.000 Person in 2009. Burkina Faso BF: Number of People Pushed Below the 50% Median Consumption Poverty Line by Out-of-Pocket Health Care Expenditure data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Burkina Faso – Table BF.World Bank.WDI: Social: Poverty and Inequality. Number of people pushed below the 50% median consumption poverty line by out-of-pocket health care expenditure; ; Wagstaff et al. Progress on Impoverishing Health Spending: Results for 122 Countries. A Retrospective Observational Study, Lancet Global Health 2017; Sum;

In 2020, the average out-of-pocket (OOP) per person spending on healthcare services by women aged 85 years and above in the U.S. amounted to ***** U.S. dollars. The per-person healthcare expenditure increased exponentially for the women in the oldest age group. In the same year, the total per-person expenditure on personal healthcare by women was also the highest in the same age group, it amounted to ****** U.S. dollars per individual.

IntroductionThis study aimed to estimate the direct medical costs and out-of-pocket (OOP) expenses associated with inpatient and outpatient care for IHD, based on types of health insurance. Additionally, we sought to identify time trends and factors associated with these costs using an all-payer health claims database among urban patients with IHD in Guangzhou City, Southern China.MethodsData were collected from the Urban Employee-based Basic Medical Insurance (UEBMI) and the Urban Resident-based Basic Medical Insurance (URBMI) administrative claims databases in Guangzhou City from 2008 to 2012. Direct medical costs were estimated in the entire sample and by types of insurance separately. Extended Estimating Equations models were employed to identify the potential factors associated with the direct medical costs including inpatient and outpatient care and OOP expenses.ResultsThe total sample included 58,357 patients with IHD. The average direct medical costs per patient were Chinese Yuan (CNY) 27,136.4 [US dollar (USD) 4,298.8] in 2012. The treatment and surgery fees were the largest contributor to direct medical costs (52.0%). The average direct medical costs of IHD patients insured by UEBMI were significantly higher than those insured by the URBMI [CNY 27,749.0 (USD 4,395.9) vs. CNY 21,057.7(USD 3,335.9), P < 0.05]. The direct medical costs and OOP expenses for all patients increased from 2008 to 2009, and then decreased during the period of 2009–2012. The time trends of direct medical costs between the UEBMI and URBMI patients were different during the period of 2008-2012. The regression analysis indicated that the UEBMI enrollees had higher direct medical costs (P < 0.001) but had lower OOP expenses (P < 0.001) than the URBMI enrollees. Male patients, patients having percutaneous coronary intervention operation and intensive care unit admission, patients treated in secondary hospitals and tertiary hospitals, patients with the LOS of 15–30 days, 30 days and longer had significantly higher direct medical costs and OOP expenses (all P < 0.001).ConclusionsThe direct medical costs and OOP expenses for patients with IHD in China were found to be high and varied between two medical insurance schemes. The type of insurance was significantly associated with direct medical costs and OOP expenses of IHD.

BackgroundWith an increasing burden of non-communicable disease in Nepal and limited progress towards universal health coverage, country- and disease-specific estimates of financial hardship related to healthcare costs need to be evaluated to protect the population effectively from healthcare-related financial burden.ObjectivesTo estimate the cost and economic burden of illness and to assess the inequality in the financial burden due to catastrophic health expenditure from 1995 to 2010 in Nepal.MethodsThis study used nationally representative Nepal Living Standards Surveys conducted in 1995 and 2010. A Bayesian two-stage hurdle model was used to estimate average cost of illness and Bayesian logistic regression models were used to estimate the disease-specific incidence of catastrophic health payment and impoverishment. The concentration curve and index were estimated by disease category to examine inequality in healthcare-related financial hardship.FindingsInflation-adjusted mean out-of-pocket (OOP) payments for chronic illness and injury increased by 4.6% and 7.3%, respectively, while the cost of recent acute illness declined by 1.5% between 1995 and 2010. Injury showed the highest incidence of catastrophic expenditure (30.7% in 1995 and 22.4% in 2010) followed by chronic illness (12.0% in 1995 and 9.6% in 2010) and recent acute illness (21.1% in 1995 and 7.8% in 2010). Asthma, diabetes, heart conditions, malaria, jaundice and parasitic illnesses showed increased catastrophic health expenditure over time. Impoverishment due to injury declined most (by 12% change in average annual rate) followed by recent acute illness (9.7%) and chronic illness (9.6%) in 15 years. Inequality analysis indicated that poorer populations with recent acute illness suffered more catastrophic health expenditure in both sample years, while wealthier households with injury and chronic illnesses suffered more catastrophic health expenditure in 2010.ConclusionTo minimize the economic burden of illness, several approaches need to be adopted, including social health insurance complemented with an upgraded community-based health insurance system, subsidy program expansion for diseases with high economic burden and third party liability motor insurance to reduce the economic burden of injury.

Additional file 3: Table S2. Estimated Average Health Care Utilization and Out-of-pocket Medical Spending Difference in Medical Aid Type II panel by difference-in-differences analysis. * Log Link with Zero-Inflated Negative Binomial Distribution was applied in the regression analysis because of exceess zeros in the outcomes. a Models additionally adjusted for individuals’ health related characteristics (mostly visited type of medical institution, lasted period of chronic disease). b Propensity score matched for sex, age, region, equivalized household disposable income, marital status, economic activity status, number of private insurance, expenditure on private insurance.

In 2010, South Africa launched a countrywide effort to scale up its voluntary medical male circumcision (VMMC) program on the basis of compelling evidence that circumcision reduces men’s risk of acquiring HIV through heterosexual intercourse. Even though VMMC is free there, clients can incur indirect out-of-pocket costs (for example transportation cost or foregone income). Because these costs can be barriers to increasing the uptake of VMMC services, we assessed them from a client perspective, to inform VMMC demand creation policies. Costs (calculated using a bottom-up approach) and demographic data were systematically collected through 190 interviews conducted in 2015 with VMMC clients or (for minors) their caregivers at 25 VMMC facilities supported by the government and the President’s Emergency Plan for AIDS Relief in eight of South Africa’s nine provinces. The average age of VMMC clients was 22 years and nearly 92% were under 35 years of age. The largest reported out-of-pocket expenditure was transportation, at an average of US$9.20 (R 100). Only eight clients (4%) reported lost days of work. Indirect expenditures were childcare costs (one client) and miscellaneous items such as food or medicine (20 clients). Given competing household expense priorities, spending US$9.20 (R100) per person on transportation to access VMMC services could be a significant burden on clients and households, and a barrier to South Africa’s efforts to create demand for VMMC. Thus, we recommend a more focused analysis of clients’ transportation costs to access VMMC services.

BackgroundCerebral palsy (CP) is the leading cause of motor disability in children and a lifelong condition with no cure, imposing a significant economic burden on families and healthcare systems. However, the economic impact of pediatric CP remains underexplored in Spain, hindering the development of cost-effective policies. Cost-of-illness (COI) studies are essential to quantify disease burden and guide resource allocation. This study aims to classify and estimate the economic and social costs of pediatric CP in Spain from a societal perspective, considering healthcare, government, and family burdens. Additionally, it evaluates the caregiving burden experienced by primary caregivers.MethodsA bottom–up, disease-specific COI study was conducted from a societal perspective using data from a population-based epidemiological registry of CP. Data collection included structured questionnaires and administrative records from regional healthcare and government sources, covering a 1-year period. The Zarit Burden Interview was used to assess caregiver burden. The study captures direct, indirect, and out-of-pocket costs, including productivity losses associated with caregiving.ResultsThe study included 148 children with CP (mean age: 9.72) and their primary caregivers (66% female, mean age: 42.97 years). Medical care costs averaged €3,801 (3.72%), while out-of-pocket expenses totalled €7,041 (6.89%), largely driven by complementary and alternative therapies used by 64% of families. Special education represented €8,932 (8.75%), whereas caregiver productivity losses were the largest component (€60,638; 59.37%). The mean annual societal cost per child was €102,135, over thirty times Spain's mean per capita healthcare expenditure. However, using a conservative assumption that valued the caregiver's time at the minimum wage, the social costs would be €70,190 per child. Children with severe motor impairment (GMFCS III–V) had nearly twice the cost of those with milder impairments (GMFCS I–II) (1.96; 95% CI: 1.92–2.01).ConclusionsThe economic burden of pediatric CP is largely driven by caregiving and non-medical costs, highlighting gaps in financial and social support. These findings call for targeted policies to reduce caregiver strain and enhance funding for assistive services, improving equity in CP care. Additionally, comprehensive cost-effectiveness analyses are needed to guide resource allocation and ensure sustainable support strategies.