The health spending per capita in Romania was the lowest in the EU, with spending less than half the EU average in 2023, the recently released report, State of Health in the EU - Romania Country Health Profile 2025, shows. At the same time, life expectancy in Romania is 5.1 years below the EU average, and the country has high preventable and treatable mortality rates.

In 2023, health expenditure per capita was EUR 1,800 (adjusted for purchasing power differences), less than half the EU average of EUR 3,832. This represented 5.8 % of GDP, also below the EU average of 10 %.

Public sources, namely government and compulsory schemes, funded 77 % of health expenditure, slightly less than the EU average of 80%, the report notes. Private funding accounted for the remaining 23% of health spending, almost all of which through out-of-pocket payments. Out-of-pocket payments are driven by spending on outpatient pharmaceuticals and dental care. Direct payments from uninsured people for certain services also contribute to the share of out-of-pocket costs.

Inpatient care accounts for a large and growing share of the country’s health spending, reaching 41% in 2023, the second-highest among EU countries. Outpatient care took up 20%, reflecting “a system that relies on resource-intensive hospital services,” the report explains. Meanwhile, preventive care and long-term care accounted for a relatively small share of health expenditure in 2023, both below the EU average.

After a sharp drop during the pandemic, life expectancy in the country began to recover in 2022 and reached an all-time high of 76.6 years in 2024. This is nonetheless still 5.1 years below the EU average, and is marked by a marked gender gap, with men living 7.6 years less than women on average. Last year, life expectancy at birth was 72.8 years for men and 80.4 years for women. This is partly due to greater exposure to men being more exposed to risk factors such as smoking and heavy alcohol drinking.

Cardiovascular diseases, including ischemic heart disease and stroke, remained the leading cause of mortality in Romania in 2022, accounting for 56 % of all deaths, according to the report. Cancer was the second leading cause of mortality, responsible for 17 % of all deaths. Other significant causes of mortality included respiratory diseases (8 %) and digestive diseases (6 %). Cardiovascular diseases are not only the leading causes of death, but also the leading causes of morbidity and disability in the country. Institute for Health Metrics and Evaluation (IHME) estimates show that 2.4 million Romanians were living with a cardiovascular disease in 2021.

In 2022, preventable mortality in Romania was the third highest in the EU at 304 deaths per 100,000 inhabitants. Ischemic heart disease, alcohol-related conditions, and lung cancer were the main causes, mirroring the high prevalence of behavioral risk factors. Treatable causes of mortality, namely deaths that could be avoided through timely and effective healthcare, were the highest in the EU in 2022, at 215 deaths per 100,000 population. Ischemic heart disease, pneumonia, and stroke were the leading causes.

The country health profiles are the joint work of the OECD and the European Observatory on Health Systems and Policies, in co-operation with the European Commission. The data are based mainly on national official statistics provided to Eurostat and the OECD.

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simona@romania-insider.com