The level of per capita health spending in a country and its changes over time are determined by a wide range of demographic, social, and economic factors, as well as the financing and organisational arrangements of the country’s health system. Given these factors, there are large variations in the level and growth of health spending across Europe.
In 2022, with spending at EUR 5 630 per person, Switzerland was the biggest spender on health in Europe, followed by Norway (EUR 5 376). Among EU countries, health spending in Germany (EUR 5 317) was 50% above the population-weighed EU average of EUR 3 533. Health spending in Austria and the Netherlands was also at least 25% higher than the EU average. Per capita health spending in the EU was lowest in Hungary, Croatia, Bulgaria and Romania, at less than EUR 1 900 per person (Figure 5.1). In some countries outside of the EU, health spending was much less. Türkiye only spent around EUR 1 000 per capita while in Albania this figure stood at less than EUR 800. This means that health spending in high-income countries in Western and Northern Europe can be over five times that in some low-spending countries in Central, Eastern or Southern Europe.
After a period of slow growth following the global financial crisis in 2008/09, annual per capita health expenditure growth (adjusted for inflation) picked up and reached 3.4% on average across EU countries between 2015 and 2019 (Figure 5.2). This ranged from very moderate growth rates of less than 1% per year in France, Sweden and Finland, to substantial average annual increases of more than 6% in Cyprus, Lithuania and Latvia, and more than 10% in Romania.
The spending trajectory in the 2019‑22 period was marked by the COVID‑19 pandemic. On average, per capita health spending grew by 3.6% across EU countries per year, slightly above the 3.4% annual growth rate observed in the 2015‑19 period. Cyprus, Latvia, Croatia and Bulgaria saw health spending growth of over 7% annually on average, while health spending grew on average less than 1% in Sweden, Belgium and Denmark.
Yet, these averages conceal significant variations during the period. With the onset of COVID‑19 pandemic in early 2020, governments allocated unprecedented financial resources to the health sector to combat COVID‑19 and address its consequences. Average health spending growth reached nearly 6% in real terms in 2020, and accelerated to 9.6% in 2021 across the EU, as significant funds were made available to track the virus, increase system capacity, develop treatment options, and eventually roll out vaccines to the population. As the pandemic moved towards the end of the acute phase in many countries, governments eased emergency health measures. In addition, emerging geo-political and economic conditions meant that other emergencies – such as the energy and cost-of-living crisis – weakened the position of health within government priorities (OECD, 2024[1]). As a result, health spending per capita dropped sharply in 2022 by 3.7% across the EU, with negative growth of over 10% in Czechia and Latvia.
Preliminary estimates for 2023 point to a further contraction of health spending in around half of EU countries. This suggests the spending trajectory of health systems is returning to pre‑pandemic levels, with few signs of significant uplifts in health spending in the short term to make health systems more resilient.
