[EQ] Measuring The Health Of Nations

 

Measuring The Health Of Nations: Updating An Earlier Analysis

Ellen Nolte and C. Martin McKee, London School of Hygiene and Tropical Medicine

HEALTH AFFAIRS - Vo l u m e 2 7, Nu m b e r 1 – January/ February 2008

 

 

Full text: http://content.healthaffairs.org/cgi/content/full/27/1/58

 

“…..The paper represents another metric through which health system performance might reasonably be gauged. This work measures the extent to which deaths that would not have occurred but for the presence of effective health care have been reduced among Organization for Economic Cooperation and Development (OECD) countries over time. Cause for concern can be seen in the authors’ finding that despite being the most prolific health care spender, the United States is falling farther behind its peer nations in overall health system performance, as measured by what the authors term "amenable mortality."

 

We compared trends in deaths considered amenable to health care before age seventy-five between 1997–98 and 2002–03 in the United States and in eighteen other industrialized countries. Such deaths account, on average, for 23 percent of total mortality under age seventy-five among males and 32 percent among females. The decline in amenable mortality in all countries averaged 16 percent over this period. The United States was an outlier, with a decline of only 4 percent. If the United States could reduce amenable mortality to the average rate achieved in the three top-performing countries, there would have been 101,000 fewer …”

 

“…..IDENTIFYING SIMPLE, PRACTICAL, AND UNDERSTANDABLE ways to assess health system performance, with its complex interlinked dimensions, remains a challenge. Health systems are complex, with multiple functions, and performance assessment frameworks are increasingly using a range of indicators to better capture these different aspects.¹

A fundamental issue relates to how to attribute population health outcomes to health care. One approach uses mortality data, which are readily available at a population level in many countries, and is based on the concept of "amenable mortality," referring to deaths from certain causes that should not occur in the presence of timely and effective health care.² Originally developed in the 1970s in the United States, the concept was subsequently adopted and updated by many researchers, especially in Europe, where it has been used to assess the quality of health care systems.³ This concept been revitalized recently as a potentially useful tool to assess the quality and performance of health systems and track changes over time…”.⁴

 

 

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