Cross-country differences in household healthcare spending.

INTRODUCTION: Health systems face financial pressures as populations age and economic growth slows, with implications for who pays for health care and for what drives expenditure growth. METHODS: We examined changes in outpatient and pharmaceutical care financing across OECD countries from 2000 to 2023. RESULTS: While overall health spending growth slowed across countries after the Great Recession, household spending grew modestly everywhere, averaging about half a percentage point growth annually. The United States stood out for persistently high out-of-pocket financing burden-over twice that of most peer countries-and for price growth, rather than utilization, driving out-of-pocket spending for pharmaceutical care. Other countries saw out-of-pocket spending driven more by volume growth and slower price growth. CONCLUSION: These patterns highlight potential affordability pressures from out-of-pocket healthcare payments, particularly in the US Policymakers should regularly monitor financial hardship from out-of-pocket payments and reconsider using cost-sharing to address health financing sustainability challenges.