"France is healthcare leader, US comes dead last: study"

[Tsukasa Buddha]

The study, entitled "Measuring the Health of Nations: Updating an Earlier Analysis," was written by researchers from the London School of Hygiene and Tropical Medicine. It looked at death rates in subjects younger than 75 that could have been prevented by timely and effective medical care.
The researchers found that while most countries surveyed saw preventable deaths decline by an average of 16 percent, the United States saw only a four percent dip.
The non-profit Commonwealth Fund, which financed the study, expressed alarm at the findings.
"It is startling to see the US falling even farther behind on this crucial indicator of health system performance," said Commonwealth Fund Senior Vice President Cathy Schoen, who noted that "other countries are reducing these preventable deaths more rapidly, yet spending far less."
The 19 countries, in order of best to worst, were: France, Japan, Australia, Austria, Canada, Denmark, Finland, Germany, Greece, Ireland, Italy, Netherlands, New Zealand, Norway, Portugal, Spain, Sweden, the United Kingdom and the United States.

Linky

But we have teh best healthcare in the world!!

Clearly the solution is to let the free market take its course and get rid of government regulations like all those countries did...

 

[Nogbad]

Unreliable - those foreigners are only getting better and living longer to spite the Market. Scoundrels that they are!

 

[Safe-Keeper]

I realize that I just posted a link to a Frontline documentary five minutes ago, but I found this interesting:
Sick around the world.

Unlike Moore's "documentary", it looks at right-wing countries, not left-wing ones, that are doing better than the US when it comes to medicine.

 

[Damien Evans]

Woohoo, third best!

 

[shadron]

It looked at death rates in subjects younger than 75 that could have been prevented by timely and effective medical care.

The researchers found that while most countries surveyed saw preventable deaths decline by an average of 16 percent, the United States saw only a four percent dip.

How is this adjusting for the fact that the bulk of such "preventable death decline" in the US occurred in the 19 and 20th centuries? Can anyone speak to the amount of "preventable death" as an absolute proportion rather than as a rate? It would seem to me that the law of diminishing returns is going to make it very hard for a country like the US to see further declines, while others may still have a way to go.

I'm not trying to diss any particular country in the study (I think the study does more than enough of that). Obviously the article doesn't attempt such a study, and it seems obvious (to me) that it should.

Had the United States performed as well as any of the top three industrialized countries, there would have been 101,000 fewer deaths per year, the researchers said.

What, for example, would it have meant if that number was an impossibly large one, say 10,000,000 just because that is the way the rates worked out?

I would tend to want to use that famous quote about statistics and lies here, but I'll resist.

 

[Skeptic Ginger]

Here are some links to more information on this paper.

First, a little more review:
Measuring the Health of Nations: Updating an Earlier Analysis

Next, the abstract:
Measuring The Health Of Nations: Updating An Earlier Analysis or same abstract on PubMed because you can link to related articles.

The original paper because the "update" isn't available for free anywhere I can find. This one should indicate the methodology, however.
From the BMJ, 2003, pdf file or same thing, html file

Martin McKee's blog discussion of the paper:
Tales from a travelling public health professor

And Ellen Nolte's web page, Ellen Nolte DiplBiol MPH PhD

 

[Kestrel]

I realize that I just posted a link to a Frontline documentary five minutes ago, but I found this interesting:
Sick around the world.

Unlike Moore's "documentary", it looks at right-wing countries, not left-wing ones, that are doing better than the US when it comes to medicine.

If you actually watched "Sicko", you should have noticed that Moore's film also looked at the health care system in the UK.

 

[JoeEllison]

It seems an odd metric, no?

 

[UnrepentantSinner]

Wait, I just read a letter to the editor in the Dallas Morning News saying health care was bad in Canada, England, France and Germany. Surely the sender knew what he was writing about.

 

[Tricky]

Wait, I just read a letter to the editor in the Dallas Morning News saying health care was bad in Canada, England, France and Germany. Surely the sender knew what he was writing about.

If it was somebody from Dallas, they were probably horrified that Botox and Liposuction weren't covered.

 

[jimecallaw]

I suspect that there might be two factors skewing the figures that have nothing to do with the quality of the healthcare available. One is distance, in most of the other countries nobody would be far from an intensive care unit, also in the states some folks might be refusing medical care, or delaying access to medical care because of religious beliefs.

 

[casebro]

They're talking about a decline in the rate of improvement? That sure in one way to make a positive thing sound negative. Voodoo statistics, anyone?

Sounds like the same kind of logic is used in the AGW theory. "It's not the temperature, or the it's change, or it's trend, it's the rate at which the trend changes".

Statistics don't lie, statisticians just invent studies that do.

 

[TV's Frank]

Isn't this a bit like saying that China has a larger GDP growth rate than the US, therefore China has a better economy?

 

[fls]

They're talking about a decline in the rate of improvement? That sure in one way to make a positive thing sound negative. Voodoo statistics, anyone?

Sounds like the same kind of logic is used in the AGW theory. "It's not the temperature, or the it's change, or it's trend, it's the rate at which the trend changes".

Statistics don't lie, statisticians just invent studies that do.

The decline in the rate of improvement was the reason the US performed poorly on this measure, but the measure that the study is referring to is the poor performance on the actual mortality rate, not the rate of change. I agree that your criticism would have been valid if that had been what they were talking about, but if you follow the links Skeptigirl provided it should clarify it for you.

Linda

 

[fls]

Isn't this a bit like saying that China has a larger GDP growth rate than the US, therefore China has a better economy?

No, it's more like discovering that China's GDP has now surpassed the US's because China had a larger growth rate than the US.

Linda

 

[casebro]

How did I misinterpret "The researchers found that while most countries surveyed saw preventable deaths decline by an average of 16 percent, the United States saw only a four percent dip." ?

That is still a decline.

 

[JEROME DA GNOME]

Ameanble

These are the diseases that the study considers amenable.

Intestinal infections
0-14
001-9
A00-9
Tuberculosis
0-74
010-8, 137
A15-9, B90
Other infections (diphtheria, tetanus, poliomyelitis)
0-74
032, 037, 045
A36, A35, A80
Whooping cough
0-14
033
A37
Septicaemia
0-74
038
A40-1
Measles
1-14
055
B05
Malignant neoplasm of colon and rectum
0-74
153-4
C18-21
Malignant neoplasm of skin
0-74
173
C44
Malignant neoplasm of breast
0-74
174
C50
Malignant neoplasm of cervix uteri
0-74
180
C53
Malignant neoplasm of cervix uteri and body of uterus
0-44
179, 182
C54, C55
Malignant neoplasm of testis
0-74
186
C62
Hodgkin's disease
0-74
201
C81
Leukaemia
0-44
204-8
C91-5
Diseases of the thyroid
0-74
240-6
E00-7
Diabetes mellitus
0-49
250
E10-4
Epilepsy
0-74
345
G40-1
Chronic rheumatic heart disease
0-74
393-8
I05-9
Hypertensive disease
0-74
401-5
I10-3, I15
Cerebrovascular disease
0-74
430-8
I60-9
All respiratory diseases (excluding pneumonia and influenza)
1-14
460-79, 488-519
J00-9, J20-99
Influenza
0-74
487
J10-1
Pneumonia
0-74
480-6
J12-8
Peptic ulcer
0-74
531-3
K25-7
Appendicitis
0-74
540-3
K35-8
Abdominal hernia
0-74
550-3
K40-6
Cholelithiasis and cholecystitis
0-74
574-5.1
K80-1
Nephritis and nephrosis
0-74
580-9
N00-7, N17-9, N25-7
Benign prostatic hyperplasia
0-74
600
N40
Maternal death
All
630-76
O00-99
Congenital cardiovascular anomalies
0-74
745-7
Q20-8
Perinatal deaths, all causes, excluding stillbirths
All
760-79
P00-96, A33
Misadventures to patients during surgical and medical care
All
E870-6, E878-9
Y60-9, Y83-4
Ischaemic heart disease*
0-74

 

[JEROME DA GNOME]

No, it's more like discovering that China's GDP has now surpassed the US's because China had a larger growth rate than the US.

Linda

Are you looking at the study?

Comparison of rankings based on disability adjusted life expectancy and standardised death rates (per 100 000; ages 0-74) from mortality amenable to health care


Now depending on exactly how this study defines both "disability adjusted life expectancy" and "mortality amenable to health care" we can derived a great number of statistics.

 

[fls]

How did I misinterpret "The researchers found that while most countries surveyed saw preventable deaths decline by an average of 16 percent, the United States saw only a four percent dip." ?

That is still a decline.

I think it would help if you read the report. You interpreted that statement correctly, but the problem is that the rate of change is not the measure used to rank the relative performance of various countries. Rather it is the 'mortality amenable to health care' that was used.

'Mortality amenable to health care' as deaths/100,000 was measured in 1997/98 and again in 2002/03. They found that the US ranked 15/19 in 1998, but dropped to 19/19 in 2003. The reason that the US moved position in rank was because of differences in rate of change, but since the US already was a poor performer, it should have been easier for the US to move up in ranking instead of down if the 'law of diminishing returns' were influencing the results.

Linda

 

[fls]

Are you looking at the study?

Comparison of rankings based on disability adjusted life expectancy and standardised death rates (per 100 000; ages 0-74) from mortality amenable to health care


Now depending on exactly how this study defines both "disability adjusted life expectancy" and "mortality amenable to health care" we can derived a great number of statistics.

Why did you quote my post? Your statements don't seem to have anything to do with what I said?

Linda