How US healthcare compares to other countries

March 14, 2018|Hematology Times

The US had greater utilization of computed tomography than the other countries, with 245 examinations per 1000 people (range for other countries, 79 to 231). And US utilization of magnetic resonance imaging was higher than most countries, with 118 examinations per 1000 people (range, 41 to 131).

However, the US ranked on the lower end of the spectrum for length of hospital stay. The length of stay for a “normal delivery” childbirth ranged from a median of 1.5 days (UK) to 5.7 days (Japan), with the US clocking in at 2 days. The median length of stay for AMI ranged from a median of 3.9 days (Netherlands) to 10.3 days (Germany), with the US at 5.4 days.

“So much of the debate about healthcare these days is about over-utilization—that somehow our health system is uniquely bad at avoiding unnecessary services,” Dr Jha said. “I think these data really put that argument to rest. Except for a few pockets, utilization is not really different between us and these high-income Northern European countries, so maybe we need to spend a little less time focusing on that and a little bit more time focusing on prices of our healthcare system.”

Outcomes

The US ranked on the lower end of the spectrum for some mortality outcomes. Thirty-day stroke mortality per 1000 patients ranged from 4.2 in the US to 10 in Canada. Thirty-day AMI mortality per 1000 ranged from 4.1 (Australia) to 8.7 (Germany), with the US at 5.5.

However, infant mortality was highest in the US, at 5.8 deaths per 1000 live births (range for other countries, 2.1 to 5.1). And life expectancy was lowest in the US, at 78.8 years (range for other countries, 80.7 to 83.9).

The researchers noted that the US had the highest percentage of overweight or obese individuals age 15 and older, at 70.1% (range for other countries, 23.8% to 63.4%), but a low percentage of smokers (11.4%; range, 11.2% to 22.4%) and moderate alcohol consumption (8.8 L per capita; range, 7.2 to 11.9).

Limitations of this study include some differences in approaches to collecting and standardizing data across countries, as well as missing data for some countries.