EDITORIAL - Ranking 37th - measuring the performance of the US health care system

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Ranking 37th — Measuring the Performance of the U.S. Health Care System

Posted by NEJM • January 6th, 2010 • Printer-friendly

J.L. Murray, M.D., D.Phil., and Julio Frenk, M.D., Ph.D., M.P.H.

Evidence that other countries perform better than the United States in

ensuring the health of their populations is a sure prod to the

reformist impulse. The World Health Report 2000, Health Systems:

Improving Performance, ranked the U.S. health care system 37th in the

world1 — a result that has been discussed frequently during the

current debate on U.S. health care reform.

The conceptual framework underlying the rankings2 proposed that health

systems should be assessed by comparing the extent to which

investments in public health and medical care were contributing to

critical social objectives: improving health, reducing health

disparities, protecting households from impoverishment due to medical

expenses, and providing responsive services that respect the dignity

of patients. Despite the limitations of the available data, those who

compiled the report undertook the task of applying this framework to a

quantitative assessment of the performance of 191 national health care

systems. These comparisons prompted extensive media coverage and

political debate in many countries. In some, such as Mexico, they

catalyzed the enactment of far-reaching reforms aimed at achieving

universal health coverage. The comparative analysis of performance

also triggered intense academic debate, which led to proposals for

better performance assessment.

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Read the full editorial here:

http://healthcarereform.nejm.org/?p=2610 & query=TOC

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