U.S. is far from the top in a study of health-care qual­ity across the globe

For 9 con­di­tions that can lead to death, it gets al­most fail­ing grades

The Washington Post Sunday - - POLITICS & THE NATION - BY ARI­ANA EUNJUNG CHA ari­ana.cha@wash­post.com More at wash­ing­ton­post.com/ news/to-your-health

Amer­i­cans grum­ble about the qual­ity of their health-care sys­tem, but when deal­ing with se­ri­ous is­sues, such as in­juries from a car crash or can­cer, most are grate­ful to live in a wealthy coun­try that has well-trained doc­tors with ac­cess to the lat­est med­i­cal tech­nol­ogy.

Yet those fac­tors don’t al­ways cor­re­late with stay­ing alive. That’s the dis­tress­ing find­ing from a global study of what re­searchers call “amenable mor­tal­ity,” or deaths that the­o­ret­i­cally could have been avoided by timely and ef­fec­tive med­i­cal care.

Christo­pher Mur­ray, a re­searcher at the Univer­sity of Wash­ing­ton, and his col­lab­o­ra­tors looked at 32 causes of death in 195 coun­tries from 1990 to 2015 to cre­ate a health-care qual­ity in­dex they used for rankings. Mur­ray de­scribed the find­ings as “dis­turb­ing.”

“Hav­ing a strong econ­omy does not guar­an­tee good health care,” he said. “Hav­ing great med­i­cal tech­nol­ogy doesn’t, ei­ther. We know this be­cause peo­ple are not get­ting the care that should be ex­pected for dis­eases with es­tab­lished treat­ments.”

The top coun­try on their list is An­dorra, the mi­crostate in the Pyre­nees moun­tains with a pop­u­la­tion of about 85,000 and an econ­omy based on tourism. The low­est is the Cen­tral African Republic, a coun­try in the mid­dle of the con­ti­nent where vi­o­lence by armed groups against civil­ians has bro­ken out in re­cent days.

As might be ex­pected, many highly de­vel­oped na­tions, such as Nor­way, Aus­tralia and Canada, scored well. Those in more re­mote ar­eas in sub-Sa­ha­ran Africa, South Asia, Latin Amer­ica and the Caribbean scored poorly.

The world’s su­per­power doesn’t rank where you might ex­pect it to. The United States scores an 80 on the in­dex, which is at the bot­tom of the sec­ond decile and puts it on par with Es­to­nia and Mon­tene­gro.

The United States mea­sures well for dis­eases preventable by vac­cines, such as diph­the­ria and measles, but it gets al­most fail­ing grades for nine con­di­tions that can lead to death. These are lower res­pi­ra­tory in­fec­tions, neona­tal dis­or­ders, non-melanoma skin can­cer, Hodgkin’s lym­phoma, is­chemic heart dis­ease, hy­per­ten­sive heart dis­ease, di­a­betes, chronic kid­ney dis­ease and the ad­verse ef­fects of med­i­cal treat­ment it­self.

“Amer­ica’s rank­ing is an em­bar­rass­ment,” ac­cord­ing to Mur­ray, who noted that U.S. health spend­ing per per­son — $9,000 annually — is more than that of any other coun­try.

The study, pub­lished late last week in the Lancet, of­fers some mod­els that the United States might want to con­sider to take steps to im­prove. It high­lights a long list of coun­tries, in­clud­ing Peru, South Korea, Niger and Jor­dan, that have had health-care qual­ity climb since 1990, meet­ing or sur­pass­ing lev­els of other coun­tries with sim­i­lar de­vel­op­ment.

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