Global healthcare study shows U.S. has room for improvement on access, quality

A global study measuring healthcare quality and access shows striking inconsistencies from country to country and within the United States systems.

The study, led by senior author Christopher Murray, M.D., director of the Institute for Health Metrics and Evaluation at the University of Washington, looks at mortality rate data from the annual Global Burden of Diseases, Injuries, and Risk Factors study encompassing 195 countries between 1990 and 2015. The results, which show “massive inequity” in terms of both access to care and the quality of care provided, appear in a recent issue of the Lancet.

Andorra topped the rankings, scoring 95 on a 100-point scale, while the Central African Republic trailed all other countries with a score of 29. Neither sophisticated medical technology nor economic strength guarantee good healthcare, according to Murray, who points out that countries with high overall scores still had gaps in their care. For instance, Norway and Australia, both of which received an overall score of 90, had low scores for cancer types for which effective treatments exist.

As for the United States, its overall score of 81 tied it with Estonia and Montenegro. The U.S. showed solid performance on vaccine-preventable diseases, though experts increasingly fear the potential for the country to backslide in this category as the anti-vaccine movement finds its political power increasing. Performance on nine treatment categories, including lower respiratory infection, diabetes, and ischemic and hypertensive heart disease, ranged in the 60s, dragging the overall number downward.

“America’s ranking is an embarrassment, especially considering the U.S. spends more than $9,000 per person on healthcare annually, more than any other country,” Murray told The Washington Post (sub. req.). His organization plans to update its findings annually, providing a benchmark index countries can use to target deficiencies in their healthcare systems and measure their progress.

The current data demonstrate regional performances largely in line with those found in existing studies, the authors write. Countries showing marked improvement in their healthcare systems since 1990 include Turkey, Peru, South Korea, the Maldives, Niger and Jordan, as well as the Baltic states.