Does the U.S. rank 37th among nations in the world in the quality of health care? Actually, it received that ranking in “overall system performance,” in a World Health Organisation (WHO) report, “World Health Report 2000: Health Systems Improving Performance,” which ranked health systems in 191 countries.
But other researchers criticise the WHO report for its eccentric methodology. For instance, its composite index of overall performance includes patient satisfaction and the accessibility of health care to low income and elderly people. But no actual patients or citizens of these countries were surveyed; rather, the report relied on a survey of public health experts, many of whom did not reside in the countries whose responsiveness to patients and the poor they were rating.
And when researchers compared the WHO rankings for 17 industrialised countries with the perceptions of their citizens recorded in a number of surveys, they found there was little relationship between the two measures. For instance,
WHO ranked the U.S. 17th, and Canada 14th, in overall system performance among industrialised countries, while in citizens’ satisfaction with health care, surveys show they rank 14th and 12th, respectively. But by another WHO measure, the health system’s responsiveness to non-health needs, the U.S. ranks first and Canada 5th.
Source: Robert J. Blendon, Minah Kim and John M. Benson, The Public Versus The World Health Organisation On Health System Performance, Health Affairs, May-June 2001.
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