Hospital spending in the United States and Canada: a comparison

Prologue: The rate at which Canada’s citizens are hospitalized is high (1,242 days per 1,000 residents) and the lengths-of-stay for all levels of care in private voluntary hospitals long (11.5 days). Canada’s hospitals negotiate their budgets every year with, for all practical purposes, the lone payer of care–the provincial health insurance plan where they operate. In this paper, Joseph Newhouse, Geoffrey Anderson, and Leslie Roos explore the question: What accounts for the substantial differences in hospital spending between such institutions in Canada and the United States? Comparisons both between and within countries are complicated by the difficulty of defining similar hospitals and similar patient populations. Nevertheless, the question they address is compelling and warrants examination. (1988)