The U.S. ranked in the bottom of the second decile in a global ranking for healthcare access and quality in 2015, according to a study published in The Lancet.
The study compared 195 countries from 1990 to 2015, mapping 32 causes of preventable death. Cause of death and risk factor estimates were taken from the Global Burden of Diseases, Injuries and Risk Factors Study. The researchers created a Healthcare Access and Quality Index, which gave each country a composite score on a scale of 1 to 100. The highest ranked country was Andorra, with a score of 95.
The findings show every country improved over the time period studied. South Korea, Turkey, Peru, China and the Maldives improved most, according to the report. However, the gap between the highest and lowest HAQ score widened — indicating healthcare disparities around the globe are widening.
Another surprising finding, according to the study's senior author, Christopher Murray, PhD, DPhil, is how poor the U.S. ranks, especially considering Americans spend more on healthcare than any other country in the world. Dr. Murray, the director of the Institute for Health Metrics and Evaluation at Seattle-based University of Washington, told Bloomberg the findings about access and quality in the U.S. are "disturbing." The findings illustrate "having a strong economy does not guarantee good healthcare," he said.
The U.S. earned an HAQ of 81 in 2015, according to the study. This is the same score earned by Estonia and Montenegro and puts the U.S. at the bottom of the second decile. Among those that scored better than the U.S.: Iceland, Switzerland, Australia, Spain, Japan, Canada, Slovenia, Greece, South Korea, Qatar, the U.K. and Kuwait. The U.S. ranking comes in just above Lebanon, Hungary, Poland and Saudi Arabia.
The study highlights the U.S.'s struggle to control diseases that require prevention or continuous care. Based on the HAQ, the U.S. scores very high (97-100) on diseases that are preventable with vaccines, such as tuberculosis, diphtheria, whooping cough, tetanus and measles. However, its lowest scores are for lower respiratory infections, chronic kidney disease, various types of heart disease diabetes and neonatal disorders.
The U.S. also scores poorly (68 out of 100) for adverse effects of medical treatment, indicating there is room for improvement in the quality of care provided.
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