A comparative study of quality of care in the UK health system with that of similar countries over time has revealed that despite recent improvements, UK lags behind other countries in several areas of care, including higher rates of preventable hospital admissions, lower cancer survival and higher mortality rates from heart attacks and strokes.
Focus on: international comparisons of healthcare quality, published by the Nuffield Trust and the Health Foundation, is pegged as one of the most comprehensive comparative studies yet that looks into the quality of care in the UK health system and gauges it in comparison of similar countries over time.
The report, which contains health care data from 15 OECD countries, is based on analysis of 27 care quality indicators between 2000 and the last year for which data are comparable (usually 2011 or 2012). Some of the indicators that have been examined provide us with a broad look at health system performance across primary care, hospital care and highly specialist care, such as for cancer.
Taken together they offer a starting point for much-needed work to understand better the reasons for variation between countries, the authors say.
Some of the indicators that were examined include: deaths within 30 days of hospital admission for a heart attack; hospital admissions for respiratory diseases; immunisation rates; volume of antibiotics prescribed; mortality following acute myocardial infarction (AMI); mortality from cancer; and screening and survival for cervical and breast cancer; among others.
Some Key Findings
- The UK fared better than other as far as flu vaccination rates and lower antibiotic prescribing rates were concerned suggesting that the country has a well-functioning primary care system. However, rates of potentially preventable hospital admissions for chronic respiratory conditions, including asthma and lung diseases, remain relatively high in the UK. By 2011 there were 61 UK admissions for asthma per 100,000 population, compared to 13.6 in Canada and 11.4 in Italy.
- UK has been improving as far as mortality from heart attacks is concerned in recent years, but still lags behind the five other countries where data are available, with 10 per cent of people over the age of 45 dying after 30 days compared to 8.2 per cent in Norway, 8.4 per cent in New Zealand, and 8.5 per cent in Sweden in 2011.
- Cancer screening is an area which UK health system is strong in with over three-quarters of 50-69 year old women being screened for breast cancer over the period, compared to fewer than 60 per cent in Australia. Cervical screening rates are also high, although have recently deteriorated in the UK.
- One of the major lagging point of the health care system in the UK is survival rates for common cancers: between 2007 and 2012 82 per cent of women survived over five years for breast cancer, compared to 87.4 percent in Sweden. The UK’s five year survival rates for cervical and bowel cancers were also worse than other countries, and overall mortality rates remain higher than comparable countries.
- There has been good progress in the UK as far as narrowing the performance gap on mortality from common strokes caused by a blood clot is concerned, but the country’s health system still underperforms than most other countries where data are available. For rarer strokes, caused by a bleed in the brain, the gap with the best performer (Sweden) has remained persistently high, but the authors say that routine international data on strokes can be problematic because of variations in how countries collect the data.
Despite the extensive study, authors have warned that the national level data used in the report will often mask considerable variations within countries, and emphasises that the level of performance on care quality indicators is also due to factors not within the control of healthcare systems, such as lifestyle choices and population health.
You can find the full report here and appendices here.
