Across Asia-Pacific countries, per capita health spending continues to rise. Low and lower-middle income countries reported an increase from 173 to 247 international dollars (in constant 2017 USD PPP) between 2010 and 2017, whereas upper middle and high income countries spending grew from 466 to 689 and from 2 922 to 3 712 international dollars (in constant 2017 USD PPP) during the same period, respectively. However, large inequalities in per capita health care spending can be observed in Asia-Pacific countries in 2017 (), ranging from only 94 international dollars (USD PPP) in Bangladesh to 4 816 international dollars (USD PPP) in Australia. The average OECD current health spending per capita in 2017 was around 16 times that of the low income countries in Asia-Pacific (3 996 versus USD PPP 247).

Health care can be paid for through a variety of financing arrangements. In some countries, health care might be predominantly financed through government schemes by which individuals are automatically entitled to health care based on their residency. In other cases, compulsory health insurance schemes (either through public or private entities) linked to the payment of social contributions or health insurance premiums finance the bulk of health spending. In addition to these, a varying proportion of health care spending consists of households’ out-of-pocket payments – either as standalone payments or as part of co-payment arrangements – as well as various forms of voluntary payment schemes such as voluntary health insurance.

Alongside economic growth, out-of-pocket spending for health care increased – on average – from 227 to 293 international dollars (USD PPP) per capita in Asia-Pacific between 2010 and 2017. However, the increase was slower than that of government spending, so the share of out-of-pocket expenditure in overall health spending has been declining across all country income groups since 2010. On average, the share of health spending paid out-of-pocket has fallen by around 3 percentage points to 19% and 29.4% in high and upper-middle income Asia-Pacific countries between 2010 and 2017, respectively, whereas it has slightly decreased to 47.4% in low and lower-middle income Asia-Pacific countries during the same period (). The pattern is quite diverse across the countries in the region. However, more than two thirds of the Asia-Pacific countries reported a decrease in the share of out-of-pocket spending, including more than 10 and 20 percentage points for Pakistan and Indonesia, respectively, while Lao PDR reported a growth of around 10 percentage points in the same period. For each dollar spent on health, more than 60 cents were “out-of-pocket” in Cambodia, Bangladesh, Pakistan, India and Myanmar in 2017.

Factors such as how care is organised and prioritised across providers, what the population needs are, and the various input costs, all affect the level of health spending across different services. Curative and rehabilitative care services comprise the greatest share – typically accounting for around 60% of all health spending across Asia-Pacific reporting countries (). Medical goods (mostly retail pharmaceuticals) take up a further 17%, followed by a growing share on preventive care, which in 2017 averaged around 8% of health spending. Administration and overall governance of the health system, together with ancillary services and long-term care covered the remainder. Across OECD countries, long-term care and pharmaceuticals accounted for a higher share of health care spending as compared to Asia-Pacific reporting countries.