Out-of-Pocket Health Expenditure

Household out-of-pocket health expenditure as share of current health expenditure. Lower is better. The raw value is shown as percent of current health expenditure; the score is inverted from the raw value.
1 Tuvalu0.0 % of health expenditure 0.0 % of health expenditure 100
2 Nauru0.7 % of health expenditure 0.7 % of health expenditure 99
2 Marshall Islands1.1 % of health expenditure 1.1 % of health expenditure 99
4 Micronesia2.6 % of health expenditure 2.6 % of health expenditure 97
5 Kiribati2.9 % of health expenditure 2.9 % of health expenditure 96
5 Solomon Islands3.2 % of health expenditure 3.2 % of health expenditure 96
7 Rwanda4.1 % of health expenditure 4.1 % of health expenditure 95
7 Botswana4.3 % of health expenditure 4.3 % of health expenditure 95
9 Tonga5.9 % of health expenditure 5.9 % of health expenditure 93
10 Oman6.3 % of health expenditure 6.3 % of health expenditure 92
10 South Africa6.7 % of health expenditure 6.7 % of health expenditure 92
12 Timor-Leste7.0 % of health expenditure 7.0 % of health expenditure 91
12 Brunei7.4 % of health expenditure 7.4 % of health expenditure 91
12 Qatar7.4 % of health expenditure 7.4 % of health expenditure 91
12 Namibia7.5 % of health expenditure 7.5 % of health expenditure 91
16 Fiji8.3 % of health expenditure 8.3 % of health expenditure 90
16 Vanuatu8.4 % of health expenditure 8.4 % of health expenditure 90
18 Luxembourg8.5 % of health expenditure 8.5 % of health expenditure 89
18 Monaco8.5 % of health expenditure 8.5 % of health expenditure 89
18 Papua New Guinea8.6 % of health expenditure 8.6 % of health expenditure 89
21 France9.2 % of health expenditure 9.2 % of health expenditure 88
21 French Guiana9.2 % of health expenditure 9.2 % of health expenditure 88
21 Guadeloupe9.2 % of health expenditure 9.2 % of health expenditure 88
21 Martinique9.2 % of health expenditure 9.2 % of health expenditure 88
21 Mayotte9.2 % of health expenditure 9.2 % of health expenditure 88
21 New Caledonia9.2 % of health expenditure 9.2 % of health expenditure 88
21 RĂ©union9.2 % of health expenditure 9.2 % of health expenditure 88
21 Saint Pierre and Miquelon9.2 % of health expenditure 9.2 % of health expenditure 88
21 Saint-Martin9.2 % of health expenditure 9.2 % of health expenditure 88
21 Tahiti9.2 % of health expenditure 9.2 % of health expenditure 88
21 Wallis and Futuna9.2 % of health expenditure 9.2 % of health expenditure 88
21 Croatia9.4 % of health expenditure 9.4 % of health expenditure 88
21 United Arab Emirates9.7 % of health expenditure 9.7 % of health expenditure 88
21 Thailand9.9 % of health expenditure 9.9 % of health expenditure 88
35 Kuwait10.0 % of health expenditure 10.0 % of health expenditure 87
35 Zambia10.3 % of health expenditure 10.3 % of health expenditure 87
35 Mozambique10.4 % of health expenditure 10.4 % of health expenditure 87
35 Ireland10.6 % of health expenditure 10.6 % of health expenditure 87
35 Zimbabwe10.6 % of health expenditure 10.6 % of health expenditure 87
35 Germany10.7 % of health expenditure 10.7 % of health expenditure 87
41 American Samoa10.9 % of health expenditure 10.9 % of health expenditure 86
41 Guam10.9 % of health expenditure 10.9 % of health expenditure 86
41 Northern Mariana Islands10.9 % of health expenditure 10.9 % of health expenditure 86
41 Puerto Rico10.9 % of health expenditure 10.9 % of health expenditure 86
41 United States10.9 % of health expenditure 10.9 % of health expenditure 86
41 Swaziland11.0 % of health expenditure 11.0 % of health expenditure 86
41 Andorra11.1 % of health expenditure 11.1 % of health expenditure 86
48 Slovenia11.7 % of health expenditure 11.7 % of health expenditure 85
48 Aruba11.8 % of health expenditure 11.8 % of health expenditure 85
48 Curacao11.8 % of health expenditure 11.8 % of health expenditure 85
48 Netherlands11.8 % of health expenditure 11.8 % of health expenditure 85
48 Sint Maarten11.8 % of health expenditure 11.8 % of health expenditure 85
48 Malawi12.0 % of health expenditure 12.0 % of health expenditure 85
48 Palau12.1 % of health expenditure 12.1 % of health expenditure 85
48 Japan12.2 % of health expenditure 12.2 % of health expenditure 85
56 Cook Islands12.7 % of health expenditure 12.7 % of health expenditure 84
56 New Zealand12.7 % of health expenditure 12.7 % of health expenditure 84
56 Niue12.7 % of health expenditure 12.7 % of health expenditure 84
56 San Marino13.1 % of health expenditure 13.1 % of health expenditure 84
56 Lesotho13.2 % of health expenditure 13.2 % of health expenditure 84
61 Samoa13.4 % of health expenditure 13.4 % of health expenditure 83
61 Sweden13.4 % of health expenditure 13.4 % of health expenditure 83
61 Norway13.7 % of health expenditure 13.7 % of health expenditure 83
61 Denmark13.9 % of health expenditure 13.9 % of health expenditure 83
61 Faroe Islands13.9 % of health expenditure 13.9 % of health expenditure 83
61 Greenland13.9 % of health expenditure 13.9 % of health expenditure 83
67 Czech Republic14.1 % of health expenditure 14.1 % of health expenditure 82
67 Finland14.1 % of health expenditure 14.1 % of health expenditure 82
67 Saudi Arabia14.1 % of health expenditure 14.1 % of health expenditure 82
67 Anguilla14.6 % of health expenditure 14.6 % of health expenditure 82
67 Bermuda14.6 % of health expenditure 14.6 % of health expenditure 82
67 British Virgin Islands14.6 % of health expenditure 14.6 % of health expenditure 82
67 Cayman Islands14.6 % of health expenditure 14.6 % of health expenditure 82
67 Gibraltar14.6 % of health expenditure 14.6 % of health expenditure 82
67 Montserrat14.6 % of health expenditure 14.6 % of health expenditure 82
67 Turks and Caicos Islands14.6 % of health expenditure 14.6 % of health expenditure 82
67 United Kingdom14.6 % of health expenditure 14.6 % of health expenditure 82
67 Colombia14.7 % of health expenditure 14.7 % of health expenditure 82
79 Iceland14.9 % of health expenditure 14.9 % of health expenditure 81
79 Canada15.3 % of health expenditure 15.3 % of health expenditure 81
81 Australia15.8 % of health expenditure 15.8 % of health expenditure 80
81 Poland16.2 % of health expenditure 16.2 % of health expenditure 80
83 Austria16.5 % of health expenditure 16.5 % of health expenditure 79
83 Cuba16.6 % of health expenditure 16.6 % of health expenditure 79
83 SĂ£o TomĂ© and PrĂ­ncipe16.7 % of health expenditure 16.7 % of health expenditure 79
83 Uruguay17.1 % of health expenditure 17.1 % of health expenditure 79
87 Gabon17.3 % of health expenditure 17.3 % of health expenditure 78
87 Cyprus17.9 % of health expenditure 17.9 % of health expenditure 78
89 Maldives18.0 % of health expenditure 18.0 % of health expenditure 77
90 Turkey19.0 % of health expenditure 19.0 % of health expenditure 76
90 Libya19.2 % of health expenditure 19.2 % of health expenditure 76
92 Liechtenstein19.7 % of health expenditure 19.7 % of health expenditure 75
92 Suriname19.7 % of health expenditure 19.7 % of health expenditure 75
92 Chinese Taipei20.2 % of health expenditure 20.2 % of health expenditure 75
92 Jamaica20.2 % of health expenditure 20.2 % of health expenditure 75
92 Slovakia20.2 % of health expenditure 20.2 % of health expenditure 75
97 Israel20.5 % of health expenditure 20.5 % of health expenditure 74
97 Antigua and Barbuda20.8 % of health expenditure 20.8 % of health expenditure 74
97 Spain20.9 % of health expenditure 20.9 % of health expenditure 74
100 Estonia21.4 % of health expenditure 21.4 % of health expenditure 73
100 Belgium21.5 % of health expenditure 21.5 % of health expenditure 73
102 Switzerland22.0 % of health expenditure 22.0 % of health expenditure 72
102 Italy22.3 % of health expenditure 22.3 % of health expenditure 72
102 Macau22.6 % of health expenditure 22.6 % of health expenditure 72
105 Romania23.0 % of health expenditure 23.0 % of health expenditure 71
105 Hungary23.1 % of health expenditure 23.1 % of health expenditure 71
105 Hong Kong23.4 % of health expenditure 23.4 % of health expenditure 71
108 Costa Rica24.1 % of health expenditure 24.1 % of health expenditure 70
108 Kenya24.2 % of health expenditure 24.2 % of health expenditure 70
110 Argentina24.5 % of health expenditure 24.5 % of health expenditure 69
110 Burundi24.5 % of health expenditure 24.5 % of health expenditure 69
110 Dominican Republic25.1 % of health expenditure 25.1 % of health expenditure 69
113 Singapore25.4 % of health expenditure 25.4 % of health expenditure 68
113 Bhutan25.5 % of health expenditure 25.5 % of health expenditure 68
113 Cape Verde25.7 % of health expenditure 25.7 % of health expenditure 68
113 Kosovo26.0 % of health expenditure 26.0 % of health expenditure 68
117 Brazil26.2 % of health expenditure 26.2 % of health expenditure 67
117 Guyana26.3 % of health expenditure 26.3 % of health expenditure 67
117 Montenegro26.3 % of health expenditure 26.3 % of health expenditure 67
117 Saint Vincent and the Grenadines26.6 % of health expenditure 26.6 % of health expenditure 67
117 Ghana26.7 % of health expenditure 26.7 % of health expenditure 67
117 Belize26.8 % of health expenditure 26.8 % of health expenditure 67
123 U.S. Virgin Islands26.9 % of health expenditure 26.9 % of health expenditure 66
123 Peru27.0 % of health expenditure 27.0 % of health expenditure 66
123 South Sudan27.1 % of health expenditure 27.1 % of health expenditure 66
123 Bolivia27.3 % of health expenditure 27.3 % of health expenditure 66
123 Madagascar27.4 % of health expenditure 27.4 % of health expenditure 66
123 Bahamas27.5 % of health expenditure 27.5 % of health expenditure 66
123 Moldova27.5 % of health expenditure 27.5 % of health expenditure 66
130 Kazakhstan27.6 % of health expenditure 27.6 % of health expenditure 65
130 Tanzania27.9 % of health expenditure 27.9 % of health expenditure 65
130 Zanzibar27.9 % of health expenditure 27.9 % of health expenditure 65
130 Congo28.0 % of health expenditure 28.0 % of health expenditure 65
130 Seychelles28.0 % of health expenditure 28.0 % of health expenditure 65
130 Portugal28.2 % of health expenditure 28.2 % of health expenditure 65
130 Russia28.4 % of health expenditure 28.4 % of health expenditure 65
137 Belarus28.5 % of health expenditure 28.5 % of health expenditure 64
137 Bahrain28.7 % of health expenditure 28.7 % of health expenditure 64
137 Djibouti28.8 % of health expenditure 28.8 % of health expenditure 64
140 Dominica29.3 % of health expenditure 29.3 % of health expenditure 63
140 Lebanon29.7 % of health expenditure 29.7 % of health expenditure 63
140 Venezuela29.7 % of health expenditure 29.7 % of health expenditure 63
143 Somalia30.8 % of health expenditure 30.8 % of health expenditure 62
144 Ecuador30.9 % of health expenditure 30.9 % of health expenditure 61
144 Malta30.9 % of health expenditure 30.9 % of health expenditure 61
144 Bosnia and Herzegovina31.0 % of health expenditure 31.0 % of health expenditure 61
144 Indonesia31.1 % of health expenditure 31.1 % of health expenditure 61
144 Lithuania31.4 % of health expenditure 31.4 % of health expenditure 61
149 Ivory Coast32.0 % of health expenditure 32.0 % of health expenditure 60
149 Serbia32.1 % of health expenditure 32.1 % of health expenditure 60
149 China32.2 % of health expenditure 32.2 % of health expenditure 60
149 Uganda32.2 % of health expenditure 32.2 % of health expenditure 60
153 Angola32.5 % of health expenditure 32.5 % of health expenditure 59
153 El Salvador32.5 % of health expenditure 32.5 % of health expenditure 59
155 Korea Republic33.7 % of health expenditure 33.7 % of health expenditure 58
155 Gambia33.8 % of health expenditure 33.8 % of health expenditure 58
157 Greece34.3 % of health expenditure 34.3 % of health expenditure 57
157 Jordan34.5 % of health expenditure 34.5 % of health expenditure 57
159 Latvia35.1 % of health expenditure 35.1 % of health expenditure 56
159 Bulgaria35.5 % of health expenditure 35.5 % of health expenditure 56
161 Paraguay36.3 % of health expenditure 36.3 % of health expenditure 55
162 Malaysia37.1 % of health expenditure 37.1 % of health expenditure 54
162 Saint Lucia37.1 % of health expenditure 37.1 % of health expenditure 54
164 Morocco37.3 % of health expenditure 37.3 % of health expenditure 53
164 Nicaragua37.6 % of health expenditure 37.6 % of health expenditure 53
164 Tunisia37.9 % of health expenditure 37.9 % of health expenditure 53
167 Congo DR38.0 % of health expenditure 38.0 % of health expenditure 52
168 Chile39.1 % of health expenditure 39.1 % of health expenditure 51
168 Vietnam39.2 % of health expenditure 39.2 % of health expenditure 51
168 North Macedonia39.6 % of health expenditure 39.6 % of health expenditure 51
171 Panama40.5 % of health expenditure 40.5 % of health expenditure 49
172 Mexico41.2 % of health expenditure 41.2 % of health expenditure 48
172 Saint Kitts and Nevis41.8 % of health expenditure 41.8 % of health expenditure 48
174 Palestine42.1 % of health expenditure 42.1 % of health expenditure 47
174 Kyrgyzstan42.3 % of health expenditure 42.3 % of health expenditure 47
174 Benin42.4 % of health expenditure 42.4 % of health expenditure 47
177 Iran43.1 % of health expenditure 43.1 % of health expenditure 46
178 Burkina Faso43.8 % of health expenditure 43.8 % of health expenditure 45
178 Mauritania43.8 % of health expenditure 43.8 % of health expenditure 45
178 India43.9 % of health expenditure 43.9 % of health expenditure 45
178 Senegal44.3 % of health expenditure 44.3 % of health expenditure 45
178 Philippines44.4 % of health expenditure 44.4 % of health expenditure 45
183 Laos44.8 % of health expenditure 44.8 % of health expenditure 44
183 Algeria45.0 % of health expenditure 45.0 % of health expenditure 44
183 Central African Republic45.0 % of health expenditure 45.0 % of health expenditure 44
186 Mauritius45.2 % of health expenditure 45.2 % of health expenditure 43
186 Trinidad and Tobago45.3 % of health expenditure 45.3 % of health expenditure 43
186 Ukraine45.3 % of health expenditure 45.3 % of health expenditure 43
189 Ethiopia46.3 % of health expenditure 46.3 % of health expenditure 42
190 Mali47.2 % of health expenditure 47.2 % of health expenditure 41
191 Albania48.3 % of health expenditure 48.3 % of health expenditure 40
192 Eritrea48.4 % of health expenditure 48.4 % of health expenditure 39
192 Grenada48.5 % of health expenditure 48.5 % of health expenditure 39
192 Mongolia48.8 % of health expenditure 48.8 % of health expenditure 39
195 Barbados49.5 % of health expenditure 49.5 % of health expenditure 38
196 Korea DPR50.4 % of health expenditure 50.4 % of health expenditure 37
197 Niger51.5 % of health expenditure 51.5 % of health expenditure 36
198 Chad51.7 % of health expenditure 51.7 % of health expenditure 35
199 Haiti52.4 % of health expenditure 52.4 % of health expenditure 34
199 Pakistan52.9 % of health expenditure 52.9 % of health expenditure 34
199 Honduras53.1 % of health expenditure 53.1 % of health expenditure 34
202 Iraq54.0 % of health expenditure 54.0 % of health expenditure 33
203 Guinea54.4 % of health expenditure 54.4 % of health expenditure 32
203 Sierra Leone54.5 % of health expenditure 54.5 % of health expenditure 32
205 Sri Lanka54.8 % of health expenditure 54.8 % of health expenditure 31
205 Western Sahara55.0 % of health expenditure 55.0 % of health expenditure 31
207 Comoros56.6 % of health expenditure 56.6 % of health expenditure 29
207 Egypt57.2 % of health expenditure 57.2 % of health expenditure 29
207 Guatemala57.2 % of health expenditure 57.2 % of health expenditure 29
210 Sudan57.4 % of health expenditure 57.4 % of health expenditure 28
211 Georgia58.8 % of health expenditure 58.8 % of health expenditure 27
212 Nepal59.4 % of health expenditure 59.4 % of health expenditure 26
213 Cambodia60.6 % of health expenditure 60.6 % of health expenditure 24
214 Guinea-Bissau61.6 % of health expenditure 61.6 % of health expenditure 23
215 Tajikistan62.4 % of health expenditure 62.4 % of health expenditure 22
216 Liberia63.2 % of health expenditure 63.2 % of health expenditure 21
217 Uzbekistan64.1 % of health expenditure 64.1 % of health expenditure 20
217 Togo64.3 % of health expenditure 64.3 % of health expenditure 20
219 Azerbaijan64.6 % of health expenditure 64.6 % of health expenditure 19
220 Equatorial Guinea66.0 % of health expenditure 66.0 % of health expenditure 18
221 Cameroon67.7 % of health expenditure 67.7 % of health expenditure 15
222 Yemen69.1 % of health expenditure 69.1 % of health expenditure 14
223 Myanmar71.1 % of health expenditure 71.1 % of health expenditure 11
224 Nigeria71.9 % of health expenditure 71.9 % of health expenditure 10
225 Syria72.4 % of health expenditure 72.4 % of health expenditure 9
226 Afghanistan77.1 % of health expenditure 77.1 % of health expenditure 4
227 Turkmenistan77.4 % of health expenditure 77.4 % of health expenditure 3
228 Bangladesh79.3 % of health expenditure 79.3 % of health expenditure 1
229 Armenia80.5 % of health expenditure 80.5 % of health expenditure 0

Last rating: June 15th, 2026

How the Raw Value Is Calculated

The raw value is the share of current health expenditure paid directly by private households. A value of 25.0 means households pay 25.0% of current health expenditure out of pocket. Lower is better.

The main source is the World Bank indicator SH.XPD.OOPC.CH.ZS. It uses the WHO Global Health Expenditure Database and measures out-of-pocket expenditure as a share of current health expenditure.

Nomadino uses the latest available non-empty country value. The raw value remains visible as a percentage; it is not converted into Nomadino points.

Where the World Bank does not provide a standalone value for a country or territory, Nomadino uses maintained replacement values. These are derived from administering state, local health financing, insurance logic, island or remote context and plausible comparator countries.

The score is inverted from the raw value: lower direct household payments produce a higher score. Very high household shares are capped in the score conversion so extreme outliers do not distort the ranking.

This indicator measures only the out-of-pocket financing share. It does not automatically rate care quality, doctor density, insurance coverage, specialist costs, medicine access or whether foreigners are covered by the system.

This means countries with very different health systems can rank close together. Germany and the United States have similar shares of direct household payments in the WHO/World Bank series, even though insurance premiums, employer insurance, tax financing, private insurance payments, medical debt and system risks are distributed very differently. Those aspects are assessed in other Nomadino indicators such as health-insurance coverage, universal health coverage, specialist costs and health insurance for foreigners.