Government expenditure on health

Data extracted on 29 February 2024

Planned article update: February 2025

Highlights

General government expenditure in the EU on health amounted to €1 221 billion or 7.7 % of GDP in 2022.

General government total expenditure on health, 2022 (% of GDP)
Source: Eurostat (gov_10a_exp)

This article analyses data on general government total expenditure on 'health' (according to the Classification of the Functions of Government - COFOG). It is part of a set of statistical articles based on general government expenditure by function.

Eurostat collects data on general government expenditure by economic function according to the international Classification of the Functions of Government (COFOG) in the framework of the European System of National Accounts (ESA 2010).

Full article

Expenditure on 'health'

In 2022 at the level of the EU, 'health' expenditure remained the second largest item of general government expenditure after expenditure on 'social protection'. In 2022 in the EU, total expenditure of general governments on 'health' amounted to €1 221 billion or 7.7 % of GDP.

Table 1: General government total expenditure on health, 2022 (% of GDP)
Source: Eurostat (gov_10a_exp)

Looking at a more detailed breakdown for the EU in 2022, 'hospital services' accounted for 3.2 % of GDP, 'outpatient services' for 2.3 % of GDP, 'medical products, appliances and equipment' for 1.1 % of GDP and 'public health services' for 0.5 % of GDP. 'Research and development on health' amounted to 0.1 % of GDP while 'not elsewhere classified expenditure related to health' stood at 0.3 % of GDP.

The largest amount of government expenditure on health was reported by Austria (9.3 % of GDP), followed by Czechia and France (both 9.1 % of GDP) and Germany (8.5 % of GDP). Among the EFTA countries, Iceland reported the largest amount (8.6 % of GDP). The smallest amounts were reported by Hungary (4.4 % of GDP) as well as Latvia (4.8 % of GDP) and Romania (4.9 % of GDP). Switzerland reported the smallest amount among the reporting EU and EFTA countries (2.3 % of GDP). While in some countries health care is organised by the private sector, most countries have government schemes.

Government 'health' expenditure by type of transaction

At the level of the EU, a bit more than half (53 %) of total expenditure on 'health' in 2022 was in the form of social cash benefits and social transfers in kind - purchased market production. In 2022, at the level of the EU, 'compensation of employees', that is wages and salaries as well as employers' actual or imputed social contributions made up 22 % of government total expenditure on health. Eighteen percent was devoted to 'intermediate consumption', consisting of government purchases of goods and services, except where these are regarded as capital formation, for example medication. Three percent of health expenditure related to capital investments in 2022, such as the purchase of new equipment or construction of new hospitals.

Evolution of general government 'health' expenditure

At the level of the EU, general government 'health' expenditure increased relatively smoothly between 1995 and 2022, amounting to 11.1 % of total expenditure in 1995 and 15.5 % of total expenditure in 2022. As a ratio to GDP, EU government health expenditure amounted to 5.9 % of GDP in 1995 and 7.7 % of GDP in 2022. In 2022, the ratio to GDP decreased by 0.4 percentage points as compared to 2021, when it had peaked at 8.0 % of GDP.

Source data for tables and graphs

The detailed tables are available here.

Data sources and availability

Reporting of data to Eurostat

Annual government finance statistics (GFS) data are collected by Eurostat on the basis of the European System of Accounts (ESA 2010) transmission programme. Member States are requested to transmit, among other tables, table 1100, 'Expenditure of general government by function' twelve months after the end of the reference period. Table 1100 provides information about expenditure of the general government sector divided into main COFOG functions and ESA 2010 categories. The transmission of the COFOG I level breakdown (divisions) is compulsory for the years 1995 onwards, whereas information on the COFOG II level (COFOG groups) is provided on a compulsory basis for the general government sector for reference years from 2001 onwards. The main reference year used in this publication is 2022 as the latest year available at EU level.

Data was extracted on 29 February 2024.

Provisional data

While a significant effort was undertaken to harmonise the recording of government measures to mitigate the economic and social impact, a full harmonisation of data for the reference year 2022 was not yet achieved. Data for the EU and euro area aggregates (2022), Belgium (2022), Germany (2020-2022), Spain (2022), France (2021-2022) and Portugal (2022) is provisional.

Definition of general government and its subsectors

The data relate to the general government sector of the economy, as defined in ESA 2010, paragraph 2.111: 'The general government sector (S.13) consists of institutional units which are non-market producers whose output is intended for individual and collective consumption, and are financed by compulsory payments made by units belonging to other sectors, and institutional units principally engaged in the redistribution of national income and wealth’.

Classification of functional expenditure of government

The Classification of the Functions of Government (COFOG) classifies government expenditure into ten main categories (divisions known as the 'COFOG I level' breakdown): general public services; defence; public order and safety; economic affairs; environmental protection; housing and community affairs; health; recreation, culture and religion; education; social protection. These divisions are further broken down into 'groups' (COFOG II level).

For 'health', the groups are

'medical products, appliances and equipment',
'outpatient services',
'hospital services',
'public health services',
'R&D health',
'health n.e.c.'

Further information is available in the Eurostat Manual on sources and methods for the compilation of COFOG Statistics.

Satellite accounts

Administrative expenditure data is additionally collected in so-called satellite accounts. In general, the amount of expenditure recorded in satellite accounts is expected to exceed the expenditure recorded under the respective COFOG division. More details on the comparability of COFOG data with satellite accounts data can be found in the COFOG manual.

Definition of general government total expenditure

Government total expenditure is defined in ESA 2010, paragraph 8.100 by using as reference a list of ESA 2010 categories. More detail is provided in the overview article on Government expenditure by function – COFOG.

Gross Domestic Product

Throughout this publication, the nominal GDP, i.e. GDP at current prices is used. The latest GDP available at time of publication is used.

Time of recording & symbols used

In the ESA 2010 system, recording is on an accrual basis, that is, when ‘economic value is created, transformed or extinguished, or when claims and obligations arise, are transformed or are cancelled.'

":" not available

"pp" percentage points

More data and information

For more country-specific notes, e.g. on missing data, please refer to the metadata published on Eurobase. The authors can be contacted at ESTAT-GFS@ec.europa.eu

Context

In the framework of the European System of National Accounts (ESA 2010), Eurostat collects data on general government expenditure by economic function according to the international Classification of the Functions of Government (COFOG) – see methodological note.