Canada ranks well in global health care access study, but room for improvement

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Canada has scored well in a global study to assess how effectively countries use their healthcare systems to avoid preventable deaths, but the country still has plenty of room for improvement.

The first ever Healthcare Access and Quality Index, released Friday, measures citizens’ access to quality health care by focusing on the death rates of 32 diseases that are usually easily treatable. Those diseases included:

  • several forms of treatable cancer, such as testicular and skin cancers (not including melanoma)
  • heart disease and diabetes
  • tuberculosis and other respiratory infections;
  • illnesses that can be prevented with vaccines (diphtheria, whooping cough, tetanus and measles);
  • maternal and neonatal disorders.

The study concludes that far too many people died from causes with well-known treatments in 2015 — even in countries with strong economies.

The U.S. performed particularly poorly, placing 35th on the index despite the country’s large economy, noted Dr. Christopher Murray, the senior author of the study and the director of the Institute for Health Metrics and Evaluation at the University of Washington.

“America”s ranking is an embarrassment, especially considering the U.S. spends more than $9,000 per person on health care annually, more than any other country,” Murray said in a statement announcing the results.

Canada placed 17th, with a score of 88, the same score as Belgium, France, Austria, and Ireland.

Canada excelled in preventing deaths from appendicitis, tuberculosis, and vaccine-preventable illnesses. But the country did not score as well in preventing deaths from Hodgkin’s lymphoma, non-melanoma skin cancer and lower respiratory infections.

The top-ranked country overall was the tiny European nation of Andorra, which earned an overall score of 95. But it should be noted Andorra’s population is only 70,000 – smaller than most Canadian cities. Iceland was No. 2, but again has a small population of 330,000.

Among nations with more than a million citizens, top honours went to Switzerland, followed by Sweden and Norway.

Dr. Murray says the study found huge disparities both between countries, and within them.

“What we have found about health care access and quality is disturbing,” he said.

“Having a strong economy does not guarantee good health care. Having great medical technology doesn”t either. We know this because people are not getting the care that should be expected for diseases with established treatments.”

At the bottom of the index were several countries in sub-Saharan Africa, with the Central African Republic suffering the worst standards of all. Afghanistan, Haiti and Yemen also ranked among the worst.

Still, the authors note that several countries have achieved progress that surpassed levels reached by other nations of similar development. These include Turkey, Peru, South Korea, the Maldives, Niger and Jordan.

The study, which appears in The Lancet, relied on data from the Global Burden of Diseases, Injuries, and Risk Factors (GBD), an annual study that uses 2,300 collaborators in 132 countries to quantify the magnitude of deaths from all major diseases and injuries.

The Healthcare Access and Quality Index used that data and focused on what a country should be able to achieve in terms of access to quality health care given its level of development.

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