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Share of health spending paid directly by patients
What this indicator measures
Share of health spending paid directly by patients at the time of care, without reimbursement by the state or an insurer.
How to read this?
A value of 20% means patients themselves pay 20% of all health spending.
Ranking : ranked from lowest to highest
In brief
The "Share of health spending paid directly by patients" ranking covers 191 countries and territories. Lowest value: Tuvalu (0 %). Highest value: Armenia (80.5 %). Median: 27.6 % (data: 2021–2024). The top 10% of countries exceed 57.4 %, while the bottom 10% stay below 8.6 %. By continent, the median is highest in Asia (39.2 %) and lowest in Oceania (7.1 %).
Median by continent
- Asia 39.2 % (45)
- Africa 33.8 % (51)
- North America 32.5 % (23)
- South America 26.7 % (12)
- Europe 20.9 % (43)
- Oceania 7.1 % (14)
Why this indicator matters
When patients pay a large share of care themselves, some go without or fall into debt. This indicator sheds light on the financial protection offered by the system.
What makes this indicator vary
It depends on health insurance, public financing, the price of care and medicines, coverage of poor populations and the private sector.
Reading precautions
The share does not say the amount paid: a low percentage can hide high spending. Reimbursement systems are not described.
Full ranking
ranked from lowest to highest
| Rank | Country | Value | Year |
|---|---|---|---|
| 1er | 🇹🇻 Tuvalu | 0 % | 2023 |
| 2e | 🇳🇷 Nauru | 0.7 % | 2023 |
| 3e | 🇲🇭 Marshall Islands | 1.1 % | 2023 |
| 4e | 🇫🇲 Micronesia | 2.6 % | 2023 |
| 5e | 🇰🇮 Kiribati | 2.9 % | 2023 |
| 6e | 🇸🇧 Solomon Islands | 3.2 % | 2023 |
| 7e | 🇷🇼 Rwanda | 4.1 % | 2023 |
| 8e | 🇧🇼 Botswana | 4.3 % | 2023 |
| 9e | 🇹🇴 Tonga | 5.9 % | 2023 |
| 10e | 🇴🇲 Oman | 6.3 % | 2023 |
| 11e | 🇿🇦 South Africa | 6.7 % | 2023 |
| 12e | 🇹🇱 Timor-Leste | 7 % | 2023 |
| 13e | 🇧🇳 Brunei | 7.4 % | 2023 |
| 14e | 🇶🇦 Qatar | 7.4 % | 2023 |
| 15e | 🇳🇦 Namibia | 7.5 % | 2023 |
| 16e | 🇫🇯 Fiji | 8.3 % | 2023 |
| 17e | 🇻🇺 Vanuatu | 8.4 % | 2023 |
| 18e | 🇲🇨 Monaco | 8.5 % | 2023 |
| 19e | 🇱🇺 Luxembourg | 8.5 % | 2024 |
| 20e | 🇵🇬 Papua New Guinea | 8.6 % | 2023 |
| 21e | 🇫🇷 France | 9.2 % | 2024 |
| 22e | 🇭🇷 Croatia | 9.4 % | 2023 |
| 23e | 🇦🇪 United Arab Emirates | 9.7 % | 2023 |
| 24e | 🇹🇭 Thailand | 9.9 % | 2023 |
| 25e | 🇰🇼 Kuwait | 10 % | 2023 |
| 26e | 🇿🇲 Zambia | 10.3 % | 2023 |
| 27e | 🇲🇿 Mozambique | 10.4 % | 2023 |
| 28e | 🇮🇪 Ireland | 10.6 % | 2024 |
| 29e | 🇿🇼 Zimbabwe | 10.6 % | 2023 |
| 30e | 🇩🇪 Germany | 10.7 % | 2024 |
| 31e | 🇺🇸 United States | 10.9 % | 2023 |
| 32e | 🇸🇿 Eswatini | 11 % | 2023 |
| 33e | 🇦🇩 Andorra | 11.1 % | 2023 |
| 34e | 🇸🇮 Slovenia | 11.7 % | 2024 |
| 35e | 🇳🇱 Netherlands | 11.8 % | 2024 |
| 36e | 🇲🇼 Malawi | 12 % | 2023 |
| 37e | 🇵🇼 Palau | 12.1 % | 2023 |
| 38e | 🇯🇵 Japan | 12.2 % | 2023 |
| 39e | 🇳🇿 New Zealand | 12.7 % | 2024 |
| 40e | 🇸🇲 San Marino | 13.1 % | 2023 |
| 41e | 🇱🇸 Lesotho | 13.2 % | 2023 |
| 42e | 🇸🇪 Sweden | 13.4 % | 2024 |
| 43e | 🇼🇸 Samoa | 13.4 % | 2023 |
| 44e | 🇳🇴 Norway | 13.7 % | 2023 |
| 45e | 🇩🇰 Denmark | 13.9 % | 2024 |
| 46e | 🇨🇿 Czechia | 14.1 % | 2024 |
| 47e | 🇫🇮 Finland | 14.1 % | 2023 |
| 48e | 🇸🇦 Saudi Arabia | 14.1 % | 2023 |
| 49e | 🇬🇧 United Kingdom | 14.6 % | 2024 |
| 50e | 🇨🇴 Colombia | 14.7 % | 2024 |
| 51e | 🇮🇸 Iceland | 14.9 % | 2024 |
| 52e | 🇨🇦 Canada | 15.3 % | 2024 |
| 53e | 🇦🇺 Australia | 15.8 % | 2023 |
| 54e | 🇵🇱 Poland | 16.2 % | 2024 |
| 55e | 🇦🇹 Austria | 16.5 % | 2024 |
| 56e | 🇨🇺 Cuba | 16.6 % | 2023 |
| 57e | 🇸🇹 São Tomé & Príncipe | 16.7 % | 2023 |
| 58e | 🇺🇾 Uruguay | 17.1 % | 2023 |
| 59e | 🇬🇦 Gabon | 17.3 % | 2023 |
| 60e | 🇨🇾 Cyprus | 17.9 % | 2023 |
| 61e | 🇲🇻 Maldives | 18 % | 2023 |
| 62e | 🇹🇷 Türkiye | 19 % | 2023 |
| 63e | 🇱🇾 Libya | 19.2 % | 2023 |
| 64e | 🇸🇷 Suriname | 19.7 % | 2023 |
| 65e | 🇱🇮 Liechtenstein | 19.7 % | 2023 |
| 66e | 🇸🇰 Slovakia | 20.2 % | 2023 |
| 67e | 🇯🇲 Jamaica | 20.2 % | 2023 |
| 68e | 🇮🇱 Israel | 20.5 % | 2023 |
| 69e | 🇦🇬 Antigua & Barbuda | 20.8 % | 2023 |
| 70e | 🇪🇸 Spain | 20.9 % | 2023 |
| 71e | 🇪🇪 Estonia | 21.4 % | 2024 |
| 72e | 🇧🇪 Belgium | 21.5 % | 2023 |
| 73e | 🇨🇭 Switzerland | 22 % | 2023 |
| 74e | 🇮🇹 Italy | 22.3 % | 2024 |
| 75e | 🇷🇴 Romania | 23 % | 2023 |
| 76e | 🇭🇺 Hungary | 23.1 % | 2023 |
| 77e | 🇨🇷 Costa Rica | 24.1 % | 2023 |
| 78e | 🇰🇪 Kenya | 24.2 % | 2023 |
| 79e | 🇦🇷 Argentina | 24.5 % | 2023 |
| 80e | 🇧🇮 Burundi | 24.5 % | 2023 |
| 81e | 🇩🇴 Dominican Republic | 25.1 % | 2023 |
| 82e | 🇸🇬 Singapore | 25.4 % | 2023 |
| 83e | 🇧🇹 Bhutan | 25.5 % | 2023 |
| 84e | 🇨🇻 Cape Verde | 25.7 % | 2023 |
| 85e | 🇧🇷 Brazil | 26.2 % | 2023 |
| 86e | 🇬🇾 Guyana | 26.3 % | 2023 |
| 87e | 🇲🇪 Montenegro | 26.3 % | 2023 |
| 88e | 🇻🇨 St. Vincent & Grenadines | 26.6 % | 2023 |
| 89e | 🇬🇭 Ghana | 26.7 % | 2023 |
| 90e | 🇧🇿 Belize | 26.8 % | 2023 |
| 91e | 🇵🇪 Peru | 27 % | 2023 |
| 92e | 🇧🇴 Bolivia | 27.3 % | 2023 |
| 93e | 🇲🇬 Madagascar | 27.4 % | 2023 |
| 94e | 🇲🇩 Moldova | 27.5 % | 2023 |
| 95e | 🇧🇸 Bahamas | 27.5 % | 2023 |
| 96e | 🇰🇿 Kazakhstan | 27.6 % | 2023 |
| 97e | 🇹🇿 Tanzania | 27.9 % | 2023 |
| 98e | 🇸🇨 Seychelles | 28 % | 2023 |
| 99e | 🇨🇬 Congo - Brazzaville | 28 % | 2023 |
| 100e | 🇵🇹 Portugal | 28.2 % | 2024 |
| 101e | 🇷🇺 Russia | 28.4 % | 2023 |
| 102e | 🇧🇾 Belarus | 28.5 % | 2023 |
| 103e | 🇧🇭 Bahrain | 28.7 % | 2023 |
| 104e | 🇩🇯 Djibouti | 28.8 % | 2023 |
| 105e | 🇩🇲 Dominica | 29.3 % | 2023 |
| 106e | 🇻🇪 Venezuela | 29.7 % | 2023 |
| 107e | 🇱🇧 Lebanon | 29.7 % | 2023 |
| 108e | 🇸🇴 Somalia | 30.8 % | 2023 |
| 109e | 🇪🇨 Ecuador | 30.9 % | 2023 |
| 110e | 🇲🇹 Malta | 30.9 % | 2023 |
| 111e | 🇧🇦 Bosnia & Herzegovina | 31 % | 2023 |
| 112e | 🇮🇩 Indonesia | 31.1 % | 2023 |
| 113e | 🇱🇹 Lithuania | 31.4 % | 2024 |
| 114e | 🇨🇮 Côte d’Ivoire | 32 % | 2023 |
| 115e | 🇷🇸 Serbia | 32.1 % | 2023 |
| 116e | 🇺🇬 Uganda | 32.2 % | 2023 |
| 117e | 🇨🇳 China | 32.2 % | 2023 |
| 118e | 🇸🇻 El Salvador | 32.5 % | 2023 |
| 119e | 🇦🇴 Angola | 32.5 % | 2023 |
| 120e | 🇰🇷 South Korea | 33.7 % | 2024 |
| 121e | 🇬🇲 Gambia | 33.8 % | 2023 |
| 122e | 🇬🇷 Greece | 34.3 % | 2023 |
| 123e | 🇯🇴 Jordan | 34.5 % | 2023 |
| 124e | 🇱🇻 Latvia | 35.1 % | 2023 |
| 125e | 🇧🇬 Bulgaria | 35.5 % | 2023 |
| 126e | 🇵🇾 Paraguay | 36.3 % | 2023 |
| 127e | 🇲🇾 Malaysia | 37.1 % | 2023 |
| 128e | 🇱🇨 St. Lucia | 37.1 % | 2023 |
| 129e | 🇲🇦 Morocco | 37.3 % | 2023 |
| 130e | 🇳🇮 Nicaragua | 37.6 % | 2023 |
| 131e | 🇹🇳 Tunisia | 37.9 % | 2023 |
| 132e | 🇨🇩 Congo - Kinshasa | 38 % | 2023 |
| 133e | 🇨🇱 Chile | 39.1 % | 2024 |
| 134e | 🇻🇳 Vietnam | 39.2 % | 2023 |
| 135e | 🇲🇰 North Macedonia | 39.6 % | 2023 |
| 136e | 🇵🇦 Panama | 40.5 % | 2023 |
| 137e | 🇲🇽 Mexico | 41.2 % | 2023 |
| 138e | 🇰🇳 St. Kitts & Nevis | 41.8 % | 2023 |
| 139e | 🇰🇬 Kyrgyzstan | 42.3 % | 2023 |
| 140e | 🇧🇯 Benin | 42.4 % | 2023 |
| 141e | 🇮🇷 Iran | 43.1 % | 2023 |
| 142e | 🇲🇷 Mauritania | 43.8 % | 2023 |
| 143e | 🇧🇫 Burkina Faso | 43.8 % | 2023 |
| 144e | 🇮🇳 India | 43.9 % | 2023 |
| 145e | 🇸🇳 Senegal | 44.3 % | 2023 |
| 146e | 🇵🇭 Philippines | 44.4 % | 2023 |
| 147e | 🇱🇦 Laos | 44.8 % | 2023 |
| 148e | 🇩🇿 Algeria | 45 % | 2023 |
| 149e | 🇨🇫 Central African Republic | 45 % | 2023 |
| 150e | 🇲🇺 Mauritius | 45.2 % | 2023 |
| 151e | 🇹🇹 Trinidad & Tobago | 45.3 % | 2023 |
| 152e | 🇺🇦 Ukraine | 45.3 % | 2021 |
| 153e | 🇪🇹 Ethiopia | 46.3 % | 2023 |
| 154e | 🇲🇱 Mali | 47.2 % | 2023 |
| 155e | 🇦🇱 Albania | 48.3 % | 2023 |
| 156e | 🇪🇷 Eritrea | 48.4 % | 2023 |
| 157e | 🇬🇩 Grenada | 48.5 % | 2023 |
| 158e | 🇲🇳 Mongolia | 48.8 % | 2023 |
| 159e | 🇧🇧 Barbados | 49.5 % | 2023 |
| 160e | 🇳🇪 Niger | 51.5 % | 2023 |
| 161e | 🇹🇩 Chad | 51.7 % | 2023 |
| 162e | 🇭🇹 Haiti | 52.4 % | 2023 |
| 163e | 🇵🇰 Pakistan | 52.9 % | 2023 |
| 164e | 🇭🇳 Honduras | 53.1 % | 2023 |
| 165e | 🇮🇶 Iraq | 54 % | 2023 |
| 166e | 🇬🇳 Guinea | 54.4 % | 2023 |
| 167e | 🇸🇱 Sierra Leone | 54.5 % | 2023 |
| 168e | 🇱🇰 Sri Lanka | 54.8 % | 2023 |
| 169e | 🇰🇲 Comoros | 56.6 % | 2023 |
| 170e | 🇬🇹 Guatemala | 57.2 % | 2023 |
| 171e | 🇪🇬 Egypt | 57.2 % | 2023 |
| 172e | 🇸🇩 Sudan | 57.4 % | 2023 |
| 173e | 🇬🇪 Georgia | 58.8 % | 2023 |
| 174e | 🇳🇵 Nepal | 59.4 % | 2023 |
| 175e | 🇰🇭 Cambodia | 60.6 % | 2023 |
| 176e | 🇬🇼 Guinea-Bissau | 61.6 % | 2023 |
| 177e | 🇹🇯 Tajikistan | 62.4 % | 2023 |
| 178e | 🇱🇷 Liberia | 63.2 % | 2023 |
| 179e | 🇺🇿 Uzbekistan | 64.1 % | 2023 |
| 180e | 🇹🇬 Togo | 64.3 % | 2023 |
| 181e | 🇦🇿 Azerbaijan | 64.6 % | 2023 |
| 182e | 🇬🇶 Equatorial Guinea | 66 % | 2023 |
| 183e | 🇨🇲 Cameroon | 67.7 % | 2023 |
| 184e | 🇾🇪 Yemen | 69.1 % | 2023 |
| 185e | 🇲🇲 Myanmar (Burma) | 71.1 % | 2023 |
| 186e | 🇳🇬 Nigeria | 71.9 % | 2023 |
| 187e | 🇸🇾 Syria | 72.4 % | 2023 |
| 188e | 🇦🇫 Afghanistan | 77.1 % | 2023 |
| 189e | 🇹🇲 Turkmenistan | 77.4 % | 2023 |
| 190e | 🇧🇩 Bangladesh | 79.3 % | 2023 |
| 191e | 🇦🇲 Armenia | 80.5 % | 2023 |
Frequently asked questions
Which country has the highest value for "Share of health spending paid directly by patients"?
The highest value is in Armenia, at 80.5 % (2023).
Which country has the lowest value for "Share of health spending paid directly by patients"?
The lowest value is in Tuvalu, at 0 % (2023).
What is the world median value of "Share of health spending paid directly by patients"?
The world median is 27.6 %, calculated across 191 countries: half of the countries are above it, the other half below.
What is the value of "Share of health spending paid directly by patients" for France?
France scores 9.2 % (2024), ranking 21 out of 191 countries (ranked from lowest to highest).
Where does the "Share of health spending paid directly by patients" data come from?
It comes from Banque mondiale (WDI), d'après OMS – Global Health Expenditure Database. Site last updated: November 8, 2026. Each country is shown with the year of its most recent value.
What does "paid directly" mean?
It is what the patient pays out of pocket at the time of care, without reimbursement by the state or an insurer.
Is a high share a problem?
It increases the risk of forgoing care or falling into debt. It does not tell the whole story of the health system.
Source and update
Source : Banque mondiale (WDI), d'après OMS – Global Health Expenditure Database. Site last updated: November 8, 2026.
Indicators in the same category : Health and healthcare system
- PhysiciansNumber of physicians (general practitioners and specialists) per 1,000 inhabitants. Figures come from national registers and their years differ from one country to another.
- Hospital bedsNumber of inpatient beds available per 1,000 inhabitants, in public and private, general and specialized hospitals.
- Nurses and midwivesNumber of nurses and midwives (including auxiliaries) per 1,000 inhabitants. Definitions and years vary somewhat between countries.
- Health expenditureCurrent health expenditure (public and private) relative to the wealth produced by the country (GDP). It includes the care and health goods consumed during the year, not buildings or equipment.
- HIV prevalenceShare of people aged 15 to 49 living with HIV (UNAIDS estimate).
- UndernourishmentShare of the population whose usual diet does not provide enough energy for an active and healthy life (FAO estimate). Very low values are shown as "2.5", meaning "2.5% or less".
- Access to basic drinking waterShare of the population with at least a "basic" drinking water service: an improved source within a 30-minute round trip.
- Access to basic sanitationShare of the population with at least "basic" toilets: improved toilets not shared with other households.
- Open defecationShare of the population without toilets who relieve themselves outdoors: fields, bushes, watercourses or other open places.
- Measles vaccinationShare of children aged 12 to 23 months who have received at least one dose of the measles vaccine (WHO and UNICEF estimate).
- New tuberculosis casesEstimated number of new tuberculosis cases (including undetected cases) in a year, per 100,000 inhabitants (WHO estimate).