When it comes to healthcare spending, what is good for the gander appears to be not so good for the goose, according to a study published online Dec. 12 in the American Journal of Public Health.

Douglas Barthold, BBA, of the Institute for Health and Social Policy at McGill University in Montreal, and colleagues use a variety of Organization for Economic Co-operation and Development (OECD) databases to study the relationship between healthcare spending and life expectancy in 27 OECD countries. The study evaluated overall efficiency and efficiency by gender.

“With a large and increasing portion of public budgets being devoted to health expenditures, the desire to improve productive efficiency in the health systems of advanced economies has become a focal point of public discourse,” they explained. “Additional spending, without specific intent and monitoring, does not necessarily promote better service or better quality of life. Identifying efficient and inefficient practices is therefore an important research activity.”

Life expectancy grew by 2.76 months and health expenditures by $68 from the 1990s through the early 2000s. For the study, all currencies were converted to purchasing power parity-adjusted 2000 U.S. dollars.

Germany ranked among the most efficient, with a 1 percent annual increase in health expenditures yielding a 0.121 percent change in life expectancy. The U.S., by comparison, gained only a 0.02 percent change in life expectancy.

Increases in health expenditures benefited men more than women. A $100 per person per year increase added an average 2.62 months of life expectancy at birth for men and 1.56 months for women, overall. Men in Germany, Switzerland, Canada, the Netherlands, Belgium and the U.S. saw the biggest gains from increased expenditures.

Barthold and colleagues reasoned men may use more care or gain more from the expenditures. They suggested that one reason for the disparity may be that men receive more appropriate and efficacious care. “[I]t is possible that men may receive a more accurate diagnosis, higher quality or more effective treatment, as has been indicated in literature on coronary heart disease and congestive heart failure.”

Other possible explanations include faster improvement from interventions among men or the fact that men start with a lower initial life expectancy.