does health care in Canada and other countries really stack up when compared
with the U.S? Supporters of a health overhaul refer to a 2000 World Health
Organization ranking that placed the United States 37th among all countries for
health care. (France was number one.) But that report has also been criticized
by some analysts for failing to follow a strict, consistent protocol and not
adjusting for a wide variety of indicators from the responding countries.
new study examines data from several health systems and highlights the role of
health care quality in the midst of the current U.S. debate, which is often
focused on improving access.
study, which was conducted by Elizabeth Docteur and Robert Berenson and
released in August by the Urban Institute, compared U.S. treatment outcomes and
other quality indicators with that of at least 30 developed countries,
including Australia, France and the United Kingdom.
an independent health policy and research analyst, said she and Berenson wanted
to see whether the scientific literature supported the idea that American
medicine really is best - a notion often "bandied about in the health
reform debate." They examined health care system research conducted during
the past 10 to 15 years and found there was "no hard evidence" that
U.S. health care quality stands out across the board. They did find that the
U.S. had high scores in some specific treatment areas, such as cancer care.
However, it didn't do as well when compared to other nations at handling
preventive care or treatment for acute conditions, including heart disease and
one of the study's most unexpected findings—depending on your political point
of view —is that the quality of health care in Canada tends to be higher than
in the U.S. The researchers looked at 10 statistically adjusted studies of
broad populations and found that five favored care in Canada. The U.S. came out
better in two. Three were inconclusive. Docteur points out the universal
coverage in Canada helps to ensure that Canadians receive the care they need
throughout their lives. "I think the main point is that our study showed
quite clearly that it is not the case that the U.S. is dominating Canada ... in
terms of quality of care," she said.
findings are not a surprise to policy wonks," said David Siegel, a quality
expert and professor at The George Washington University's School of Public
Health and Health Services. Siegel—who was not involved in the study but said
the authors used "the best information out there for
comparison"—thinks their findings have the potential to be a "myth
Docteur said she hopes that her findings will
draw more attention to quality issues, which have been a "bit of a
sleeper" in the current debate. The research made it clear that although
it's necessary to find a way to cover more people to improve the country's
health system, "just solving the problem of the uninsured is not going to
be enough." She said she would like to see the debate reframed from a
discussion on quality being at risk to a dialogue considering what the best
performers are doing.
Source: Kaiser Health News