How Does the Quality of Care Compare in Five Countries? Peter S. Hussey Johns Hopkins University and the Commonwealth Fund International Working Group.

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Presentation transcript:

How Does the Quality of Care Compare in Five Countries? Peter S. Hussey Johns Hopkins University and the Commonwealth Fund International Working Group on Quality Indicators

“Americans have the best health care system in the world”

Previous International Comparisons: Little on Clinical Quality WHO OECDWorld Bank

Commonwealth Fund International Working Group on Quality Indicators 5-country collaboration –Australia, Canada, New Zealand, the United Kingdom and the United States Representation –Government agencies (AHRQ and its counterparts) –International organizations (OECD, WHO) –Research organizations (IOM, RAND) –Nuffield Trust as cosponsor Directors –Gerard Anderson, Ph.D. –Arnold Epstein, M.D. –Robin Osborn

Indicator Selection Criteria Scientific soundness Interpretability Actionability Importance Feasibility

Result: 21 Indicators Cancer survival and screening rates Transplant survival rates Heart attack and stroke case-fatality rates Avoidable mortality rates (e.g., asthma) Vaccination rates (flu, polio)

Main Findings No country consistently scores best or worst Each country scores highest on at least one indicator Each country scores lowest on at least one indicator

Breast Cancer 5-Year Survival US Best Percent of Women Surviving Five Years After Breast Cancer Diagnosis / /

/ /011995/ /01 Kidney Transplant Survival US Worst Percent of People Surviving Five Years After a Kidney Transplant

Childhood Leukemia 5-Year Survival Canada Best Percent of Children Age 0-14 Surviving Five Years After Leukemia Diagnosis / /

30-Day Acute Myocardial Infarction Case-Fatality Rate Canada Worst Percent of People Admitted with an AMI Who Die in the Hospital within 30 Days Age-standardized Rate, Age (%) Australia7.3 Canada11.1 New Zealand8.8

Asthma Mortality Rates Per 100,000 People Age 5-39, Unexplained Trend Number of Deaths Due to Asthma per 100,000 People Age 5-39 (Age-Standardized)

US Conclusion Best of five countries on 4 indicators 2 nd or 3 rd on 10 indicators 4 th or 5 th on 5 indicators Highest spending does not always buy best quality

Next Steps More countries More indicators Investigate differences Contact: