Chapter 2

1.1 - The evolution of health expenditure in
Italy and in OECD Countries1 Francia L. 2 , Mennini F.S. 2
1.1.1 Introduction
As already pointed out in previous issues of the CEIS Health Report (2003, 2004, 2005 3 ),
OECD countries continue to employ considerable resources to nourish their health care
systems. With the aim of ensuring continuity of information and comparison with the
trend in health expenditure in other OECD countries, in this issue, too, we shall analyse
the results achieved by Italy and other countries in the OECD area considered in terms of
expenditure. In 2004, the last year for which data for an international comparison are
available, health expenditure reached an average of 9,5% of GDP in OECD countries
(Table 1) 4 . This year, too, Italy remains below the OECD average but in line with the EU
countries examined, with health expenditure of 8,4% of GDP (against 7,9% in 2000). The
USA continues to have the highest health expenditure ratio at 15,3% of GDP (against
13,3% in 2000).
Continuing technological development in the health field, the ageing of the population
and rising expectations in the population are among the principal factors determining the
steady rise in health expenditure, which has continued to grow faster than the overall
economy during the last decade (OECD 2005; Colombo, Mennini 2004). The greater rise
in health expenditure than in the economy as a whole manifested itself even before the
recent slowdown in the overall economy 5 .
During the ‘nineties, the difference between growth in health expenditure and that in the
economy averaged over one percentage point in OECD countries. As in the comparison
of the 2002 data, so also in 2004 (the last year for which data for comparison are available)
health expenditure in Italy continued to rise, though slightly more slowly than in the
leading OECD countries. These continuing accelerations have increased the concern of
policy makers, not only in Italy, over the financial sustainability of health systems. The
greater part of health expenditure is financed from public resources and consequently
exerts great pressure on the already hard pressed budgets of individual countries.
1 The latest data collection, OECD Health Data 2006, was used as the data source for the present contribution. The authors
thank Francesca Colombo (Health Policy Unit, OECD, Paris) for the paper in the CEIS Health Report 2004 which has
alllowed us to complete the present work.
2 CEIS Sanità, Faculty of Economics, University of Rome “Tor Vergata”.
3 See Francia L, Mennini FS (2003); Colombo F, Mennini FS (2004); Francia L, Mennini FS (2005).
4 The mean does not include the Czech Republic, Hungary, Italy, Korea, Mexico, Poland, Slovakia and Turkey.
5 See Colombo F, Mennini FS, 2004.
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CEIS Health Report 2006