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Spain: Health System Costs for Consumers

Spain: Health System Costs for Consumers

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Annual household out-of-pocket payment, current USD per capita (2019): $591

Source: Global Health Expenditure Database. Health expenditure series. Geneva: World Health Organization. Last accessed July 21, 2022.


Out-of-Pocket Spending as Share of Final Household Consumption (%) (2019): 3.5%

Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.


“Out-of-pocket (OOP) payments increased steadily between 2010 and 2014, before falling slightly since 2015 to reach 24 % of total health expenditure in 2017. This is well above the EU average of 16 %. OOP payments mainly consist of co-payments for pharmaceuticals and medical devices outside hospitals. After the 2012 reform, the level of cost-sharing for pharmaceuticals was increased and based on income level and employment status, including a monthly spending cap to protect pensioners (Section 5.2).”

Source: OECD/European Observatory on Health Systems and Policies (2019), Spain: Country Health Profile 2019, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.


“Public expenditure represents 71.1% of total health expenditure; this percentage decreased from 1995 to 2005 (from 72.2% to 70.6%), increased between 2005 and 2010 (up to 74.4%) and dropped again until 2015 (71.1%). In turn, private expenditure on health (as a percentage of total health expenditure) followed a U-shaped progression over the period, with a strong change in trend in 2010. Since then, this share increased to 28.9% in 2015. Voluntary health insurance, as part of private expenditure on health, grew from 1995 to 2005 (12.1% to 18.9%), decreasing thereafter and reaching 14.9% in 2015. Out-of-pocket (OOP) spending as a percentage of total health expenditure decreased until 2010 (from 23.5% to 22.1%), increasing again thereafter (to 23.9% in 2015) (MSSSI, 2017g).”

Source: Bernal-Delgado E, García-Armesto S, Oliva J, Sánchez Martínez FI, Repullo JR, PeñaLongobardo LM, Ridao-López M, Hernández-Quevedo C. Spain: Health system review. Health Systems in Transition, 2018;20(2):1–179.


Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.


Page last updated July 21, 2022 by Doug McVay, Editor.

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