Breaking News
August 16, 2018 - New project aims to study growth of water-based microorganisms
August 16, 2018 - New research confirms link between DDT exposure and autism
August 16, 2018 - Neurodevelopmental Anomalies, Birth Defects Linked to Zika ID’d
August 16, 2018 - Risk of heart failure up in ALVSD patients with diabetes
August 16, 2018 - Study reveals role of RUNX proteins in DNA repair
August 16, 2018 - New research finds no harm from average salt consumption
August 16, 2018 - Researchers develop new way of testing bacterial resistance to antibiotics
August 16, 2018 - Magnetic gene in aquarium fish could open doors to treatment for epilepsy, Parkinson’s
August 16, 2018 - Five tips for successful long-term breastfeeding
August 16, 2018 - Researchers identify brain networks involved in object naming
August 16, 2018 - Promoting HPV Vaccine Doesn’t Prompt Risky Sex by Teens: Study
August 16, 2018 - Treating Rheumatoid Arthritis: Search for a Cure
August 16, 2018 - Research shows in the long run, charcoal toothpaste likely won’t whiten teeth
August 16, 2018 - Seattle Children’s opens new clinic to provide convenient access to pediatric specialty care services
August 16, 2018 - Curious case of the lost contact lens
August 16, 2018 - GN Hearing unveils world’s first Premium-Plus hearing aid
August 16, 2018 - Parental life span linked with increased longevity and health in daughters
August 16, 2018 - Health leaders reveal ten most important medicines in NHS history
August 16, 2018 - Mobile health devices diagnose hidden heart condition in at-risk populations
August 16, 2018 - When it comes to shedding pounds, it pays to think big
August 16, 2018 - Liva Healthcare announces appointment of Thomas Cooke as clinical services manager in the UK
August 16, 2018 - New digital pharmacy aims to help people living with chronic care conditions
August 16, 2018 - Preventing ACL injuries in high school athletes
August 16, 2018 - Experts provide insight into novel concepts and approaches for stroke rehabilitation
August 16, 2018 - Scientists reverse congenital blindness in mouse model
August 16, 2018 - Study shows link between use of benzodiazepines and increased risk of Alzheimer’s disease
August 16, 2018 - Study provides new insight into how ‘trash bag of the cell’ traps and seals off waste
August 16, 2018 - Trial shows PARP inhibitor as novel treatment option for patients with advanced breast cancers
August 16, 2018 - Prenatal exposure to violence increases toddlers’ aggressive behavior to their mothers
August 16, 2018 - Can manipulating gut microbes improve cardiac function in patients with heart failure?
August 16, 2018 - Hearts of newborn piglets can completely heal after heart attacks
August 16, 2018 - Ablating the mutant p53 gene in mice with colorectal cancer inhibits tumor growth
August 16, 2018 - Higher BMI in people with prediabetes related to evening preference and lack of sufficient sleep
August 16, 2018 - Using peripheral nerve blocks to treat facial pain may produce long-term pain relief
August 16, 2018 - Neural stem cells are the key to tail regeneration
August 16, 2018 - Study compares genetic and neural contributions to ADHD in children with or without TBI
August 16, 2018 - Adding energy drinks to alcohol may exacerbate negative effects of binge drinking
August 16, 2018 - Eye Examination Can Help Detect Abuse in Children
August 16, 2018 - Know the Difference: Rheumatoid Arthritis or Osteoarthritis?
August 16, 2018 - From ‘sea of mutations,’ two possible cancer links rise to the surface
August 16, 2018 - Does medical school take too long?
August 16, 2018 - Brown University researchers reveal key physical properties of ‘giant’ cancer cells
August 16, 2018 - Regular resistance training improves exercise motivation
August 16, 2018 - Feds urge states to encourage cheaper plans off the exchanges
August 16, 2018 - Seven activities that prevent you from getting quality sleep during summer
August 16, 2018 - Five ways to tell if your baby is getting enough milk from breastfeeding
August 16, 2018 - From Pigs to Peacocks, What’s Up With Those ‘Emotional-Support Animals’?
August 16, 2018 - Breast cancers enlist the help of normal cells to help them spread and survive
August 16, 2018 - Engaging with “high-need” patients outside the clinic
August 16, 2018 - Research illuminates how online forum may offer suicide prevention support for males
August 16, 2018 - Researchers identify way to grow immune cells at large scale for preventing cancer reoccurrence
August 15, 2018 - Keck Medicine of USC’s hospitals ranked among nation’s best for the 10th consecutive year
August 15, 2018 - Researchers compare existing approaches for automating diagnostic procedures of skin lesions
August 15, 2018 - Autism risk determined by health of mom’s gut, research reveals
August 15, 2018 - WELL for Life challenges you to explore the great outdoors
August 15, 2018 - ‘Zombie’ gene protects elephants from cancer, study finds
August 15, 2018 - Ebola outbreak in Congo spreads to active combat zone
August 15, 2018 - Study highlights pollution exposure of babies in prams
August 15, 2018 - Study provides insight into link between sleep apnea and lipid metabolism
August 15, 2018 - New study focuses on promise of gene therapy for Amish nemaline myopathy
August 15, 2018 - Researchers discover new approach to alleviate chronic itch
August 15, 2018 - Uncovering the Mysteries of MS: Medical Imaging Helps NIH Researchers Understand the Tricky Disease
August 15, 2018 - Autistic people at greater risk of becoming homeless – new research
August 15, 2018 - New imaging technique can spot tuberculosis infection in an hour
August 15, 2018 - Scientists study effects of eating breakfast versus fasting overnight before exercise
August 15, 2018 - Talking with children about suicide could save lives
August 15, 2018 - Grip strength of children predicts future cardiometabolic health
August 15, 2018 - New polyclonal immunotherapy successfully neutralizes Ebola virus
August 15, 2018 - Innovative oncofertility program launched by RMA of New York and Mount Sinai Health System
August 15, 2018 - Study shows efficacy, safety of AAV5-based gene therapy to treat sheep model of achromatopsia
August 15, 2018 - Simple score helps predict which hospitalized heart attack patients are at high risk of readmissions
August 15, 2018 - New discoveries show how protein droplets do more than keep cells’ interiors tidy
August 15, 2018 - Study shows impact of optimizing airport flight patterns on human health
August 15, 2018 - Life experiences of feeling unwanted or unplanned associated with attachment insecurity
August 15, 2018 - ACS Briefing Discusses Use of Lessons From Combat Care
August 15, 2018 - Study identifies distinct origin of ADHD in children with history of brain injury
August 15, 2018 - IgG3 antibody stops B cells from fighting pathogens in HIV patients
August 15, 2018 - Scientists discover key vulnerability of mixed lineage leukemia
August 15, 2018 - College students may experience pressures from secondary exposure to opioid abuse
August 15, 2018 - Powerful new microscope reveals inner workings of human cells with unprecedented clarity
Global healthcare access and quality improved from 2000-2016

Global healthcare access and quality improved from 2000-2016

image_pdfDownload PDFimage_print

Healthcare access and quality improved globally from 2000-2016 due in part to large gains seen in many low and middle-income countries in sub-Saharan Africa and Southeast Asia, according to the latest data from the Global Burden of Disease study published in The Lancet.

Despite this, some countries saw progress slow or stall over this time. The authors say that their findings may be a warning sign that some countries’ health systems are not evolving at the same rate as population health needs, especially as many non-communicable diseases and cancers become more common.

“These results emphasise the urgent need to improve both access to and quality of healthcare, otherwise health systems could face widening gaps between the health services they provide and the disease burden in their population,” says senior author of the study Dr. Rafael Lozano, Institute of Health Metrics and Evaluation at the University of Washington, USA. “Now is the time to invest to help deliver health systems for the next generation, and accelerate progress in the Sustainable Development Goal era.” 1

The study used an index to measure the quality and accessibility of healthcare, based on 32 causes of death which should be preventable with effective medical care. Each of the 195 countries and territories assessed were given a score between 0-100. For the first time, the study also analysed healthcare access and quality between regions within seven countries: Brazil, China, England, India, Japan, Mexico, and the USA.

In 2016, the global average healthcare access and quality score was 54.4, increasing from 42.4 points in 2000. Disparities between countries remained similar in 2016 and 2000, with a 78.5 point gap between the best and worst performing countries in 2016 (18.6 in the Central African Republic and 97.1 in Iceland), compared with 79.3 points in 2000 (13.5 in Somalia and 92.8 in Iceland).

Country rankings

The five countries with the highest levels of healthcare access and quality in 2016 were Iceland (97.1 points), Norway (96.6), the Netherlands (96.1), Luxembourg (96.0), and Finland and Australia (each with 95.9). While the countries with the lowest scores were the Central African Republic (18.6), Somalia (19.0), Guinea-Bissau (23.4), Chad (25.4), and Afghanistan (25.9).

There were major gains in healthcare access and quality in many countries in sub-Saharan Africa and Southeast Asia between 2000-2016, with Ethiopia, Rwanda, Equatorial Guinea, Myanmar and Cambodia seeing among the biggest improvements. Meanwhile, progress in the USA and some Latin American countries (including Puerto Rico, Panama and Mexico) slowed or stalled over the same time.

The authors also analysed healthcare access and quality locally within Brazil, China, England, India, Japan, Mexico, and the USA. They found that China and India had the widest disparities in healthcare access and quality with 43.5 and 30.8 point differences, respectively. Japan had the narrowest differences with a 4.8 point difference.

Brazil—key findings

Overall in 2016, the score for Brazil’s healthcare access and quality was 63.8, placing it 96th out of 195 countries (up from 46.5 in 1990).

In 2016, there was a 20.4 point difference between the best- and worst-performing states (from 75.4 in the Federal District to 55.0 in Maranhão). Northern states had the highest scores on healthcare access and quality (Federal District, Sao Paulo, Santa Catarina, Rio Grande do Sul, Parana, Rio de Janeiro, Minas Gerais, Espirito Santo).

Between 1990-2016, inequalities between states slightly increased by 3.2 points (from a 17.2 point difference in 1990, to a 20.4 point difference in 2016).

China—key findings

Overall in 2016, the score for China’s healthcare access and quality was 77.9, placing it 48th out of 195 countries.

Between 1990 and 2016, China significantly increased its score for healthcare access and quality (an increase of 35.5 points), achieving some of the most pronounced gains worldwide. China achieved substantial gains during both time periods studied, but ultimately accelerated its progress from 2000 to 2016.

Of all seven countries studied in-depth, China had the widest disparities between its provinces—a 43.5-point difference (ranging from 91.5 in Beijing to 48.0 in Tibet). Provinces in the East generally had better scores on healthcare access and quality than the West of the country.

England/UK—key findings

Overall in 2016, the score for the UK’s healthcare access and quality was 90.5 (up from 78.0 in 1990), placing it 23rd out of 195 countries 2.

England saw local performance vary. In general, higher performance was primarily found in southern England, with South East England scoring highest on healthcare access and quality (92.8 in 2016) while North East England scored lowest (87.8 in 2016).

India—key findings

Overall in 2016, the score for India’s healthcare access and quality was 41.2 (up from 24.7 in 1990), placing it 145th out of 195 countries.

India’s gap between the highest and lowest scores on healthcare access and quality increased from 1990 to 2016 (from a 23.4 point difference to a 30.8 point difference). Goa and Kerala had the highest scores in 2016, each exceeding 60 points, whereas Assam and Uttar Pradesh had the lowest, each below 40.

Japan—key findings

Overall in 2016, the score for Japan’s healthcare access and quality was 94.1 points, placing it 12th out of 195 countries. Since 1990, Japan saw its score increase 13.2 points (from 80.9 points in 1990).

Among countries with subnational assessments, Japan had the smallest differences between prefectures—with a gap of 4.8 points (from 95.1 in Tokyo and Nagano to 90.3 in Okinawa) – and all prefectures scoring more than 90 points in 2016. This gap between prefectures reduced from a 8.1-point difference in 1990.

Mexico—key findings

Overall in 2016, the score for Mexico’s healthcare access and quality was 66.3 points, placing it 91st out of 195 countries. Since 1990, Mexico saw its score increase 20.8 points (from 45.5 points in 1990).

In 2016, there was a 17.0 point gap between the best- and worst-performing states (from 72.8 in Nuevo Leon to 55.8 in Chiapas). The lowest scores were generally concentrated along Mexico’s southern border.

Mexico’s pace of progress was faster from 1990-2000 as compared with 2000-2016. Nonetheless, state-level differences in Mexico narrowed slightly (from a 20.9 point difference in 1990, to 17.0 point difference in 2016).

USA—key findings

Overall in 2016, the score for the USA’s healthcare access and quality was 88.7 points, placing it 29th out of 195 countries.

The USA had considerable disparities between states—with a gap of 11.0 points (from 92.5 in Massachusetts to 81.5 in Mississippi). Health care access and quality was highest in the north eastern states, Minnesota, and Washington state.

Between 1990-2016, the country’s overall score improved by 8.0 points (from 80.7 in 1990) and inequalities between states shrunk (16.7 point difference in 1990, vs 11.0 point difference in 2016). However, most of this change occurred between 1990-2000 (the gap between best- and worst-performing states shrunk to 11.5 points in 2000), and comparatively little progress has occurred from 2000-2016.

The authors note some limitations, including that their estimates rely on accurate recording of deaths in each of the 195 countries analysed. The study does not take into account the differences between primary and secondary healthcare, and so cannot distinguish if changes in the healthcare access and quality index over time are due to improved primary, secondary or overall care. In addition, not all elements of healthcare access and quality are included in the index, and future work will analyse this more widely.

Writing in a linked Comment, Dr. Svetlana V Doubova, Mexican Institute of Social Security, Mexico, says: “In the past, the priorities of public health and health-care services focused on infectious diseases and maternal and child health; today, the unbridled growth of non-communicable diseases is an additional priority. Also, health systems in different countries (eg, Brazil and Colombia) show a tendency to introduce the health-care networks that integrate primary, secondary, and tertiary care, in which investments should aim at strengthening the continuum of care across the different health-care providers. The study by Lozano and colleagues provides a comprehensive measure of the progress and the magnitude of the gaps among and within countries to provide accessible, high-quality health care.”


Explore further:
Which countries have the best healthcare?

More information:
The Lancet (2018). www.thelancet.com/journals/lan … (18)30994-2/fulltext

Journal reference:
The Lancet

Provided by:
Lancet

About author

Related Articles