Wednesday, June 23, 2010

Quality First: Apparently Not In US Healthcare

Yesterday I commented on patient safety becoming a victim of the recession. Today comes news that The US ranks dead last in healthcare quality when compared with six other industrialized nations. The study comes from a private Washington DC based foundation called The Commonwealth Fund. The major factors leading to this conclusion are the lack of access and equity in healthcare along with the inefficiency of providers.

Currently the US spends the most on healthcare of the countries studied ($7,290 per capita per year) and for this it gets the least of the seven countries. The Netherlands ranked first, spending only $3,837 per capita annually. Karen Davis, the foundation's president, thinks that the new healthcare reform law will improve this ranking when it is fully implemented in 2014. I'm not so sure.

Other nations have improved access through universal coverage and improving the relationship between patients and providers. One of the options they have set up is the development of medical "homes" which are being funded here as trial projects under the reform legislation. But will these be enough to make a significant impact. We seem to have the best system in the world for fixing people who are medically broken, but the worst system for preventing people from getting broken in the first place. The demonstration projects and funding for primary care under healthcare reform just scratch the surface on these issues. Also the improved coverage under reform still leaves 23 million Americans without any healthcare coverage.

By the way, this is not the first time that the US has ranked last on this list. We also came in last in 2007, 2006, and 2004. Also of note, the other countries studied besides the US and the Netherlands are The United Kingdom, Australia, Canada, Germany, and New Zealand.

Quality first and finances follow. Just look at the Netherlands.

More on this later.

Mark Brodeur

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