Comparing the Quality of Care in America with other Countries
Introduction
The perception of many of the Americans about quality of healthcare offered varies across the social economic distribution patterns. Those who are not able to afford the services and those who have been engaged in the Obama care scheme believe that the quality of health care has improved compared to other countries. Those who have private insurance schemes in many instances believe that the quality upon the introduction of the free healthcare for all has been compromised. This statement is debatable but only facts can be used to state the correct position of the quality of healthcare in America. Comparatively, many people believe that other countries have quality healthcare but not as good as that which belongs to the American systems. This statement has been offered discretely since the believers of superior quality care in America indicate that the introduction of the health reform threatens its quality. The international data on quality that rates countries in terms of their quality health provisions indicates that every country performs best in a given area of care and worst in another area comparatively. Despite this fact, limited research on comparative quality has been carried out, and therefore it may be impossible to benchmark the standards of quality that clinicians and other health personnel ought to put so that they can equal other countries’ level (Improving Value in Health Care: Measuring Quality, 2010). In the US, the institute of medicine has been trying to focus on the quality of medical care, with interest in ways to improve the quality of care. Despite the mixed thoughts on the standard of quality in the United States, and the spotty coverage as well as the high costs and other problems associated with the system, many people hold that it is the best in the world. The empirical basis for this assumption is unclear since data provided on the life expectance and infant mortality rates United States lower than most of the comparing countries. Regardless, the question that ponders in one’s mind is whether this is true or not. This being the case, this paper will aim at comparing the different aspects of healthcare between the United States and other countries putting emphasis on the quality, health lives, access, costs, efficiency and equity, and options that can be employed to improve on the quality of health care.
Characteristics of high quality care
Based on all the researches that have been done, the US health care system happens to be the most expensive globally. Despite this fact, the research that was carried out by the Common Wealth Fund (2014), indicates that US ranks in the lower quartile in most of the areas that were researched on, of course except in the cost of care. The same report indicates that in the 2010, 2007, and previous studies, the edition of Mirror, Mirror ranked the US last with the United Kingdom being ranked first followed by Switzerland (see exhibit ES1 for the full list). The report presented by the Mirror Mirror addressed the quality of care, access, efficiency, equity, health expenditures and health lives in its rankings. The report indicated that the only difference that differentiates the US and the other countries was the absence of the universal health care insurance. On many health outcomes, the United States underperforms. This may be prompted by the fact that US physicians receive late information, lack the coordination care as well as having difficulties in health care administration. As other countries embrace modern technology in the health information systems, US physicians and hospitals are trying to catch up. This may be aided by the passing of the affordable care act, which would encourage efficient organizations.
In terms of quality, the indicators presented were effective care, safe care as well as the patient centered care and coordinated care (Common Wealth Fund, 2014). Among the comparatives, the US fared well in the safe care and the effective care. Though improvements have been going on in the quality section, the underperforming of the country in centered and coordinated care drags the performance of the US. It is only through the adoption of technology in the health information system that the physicians can be able to monitor, identify and coordinate care for the patients especially those suffering from chronic conditions.
Since the United States is not covered by the universal health insurance scheme, the minority group is affected, as they have to fund themselves since the cost is more compared to other countries (Thomson Et al., 2013). Despite the fact that the American system has a rapid care section for the specialized health care services, many of the Americans shy away from them because of the cost and therefore prefer the primary care sections. Countries like the UK and Germany have a universal coverage and therefore everybody in the population is able to access healthcare unlike the American healthcare system (Kulesher & Forrestal, 2014). The United States ranks poorly because of the way it handles the national health expenditures and administration costs. This implies that many of the Americans are likely to misuse the emergency service for conditions that a regular doctor would have covered.
The common wealth fund, (2014)
Life expectance and mortality rate
The US life expectancy is well below average when compared with other developed countries. This fact does not account for the deaths that are not health related. Life expectancy at the same time ranks poorly, though this is as a result of indicators outside the health system. This fact contradicts the common wealth fund opinion and observation that the quality of health care is as a result of health related issues. The life expectance of the older adults is around 65 years. This is as a result of the Medicare insurance cover that is accorded to the elderly. The Medicare for the elderly rates higher in the United States than in many of the Organization for Economic Co-operation and Development though not the best (Crimmins, Preston, Cohen & National Research Council (U.S.), 2010). In the study done on amenable deaths among 19 countries, America had the highest deaths (Butler, 2012).
Us-Canada comparison
Research done comparing the outcomes and effectiveness of healthcare between US and Canada reveals that each of the two countries performed better in different studies. This could be explained by the fact that policy interests, data availability among other factors contributed to the varying results. All in all, the studies done portray Canada as having a higher quality healthcare than the United States (Boychuk, 2008). The studies done between the two countries addressed various health issues including chronic illnesses, cancer, surgical procedures among others.
Overuse of health services
Of the studies that have been done on the use of certain procedures and surgeries, the United States had a higher use of these services thus putting the American life at risk. The degree of variation in this case arises from the variation in the number of population getting a given service and the actual data that would be expected. This leaves the query as to whether some countries underuse certain procedures or some other overuse the same. For example, studies done in the OECD indicates that the number of caesarian sections done per every 100 live births ranges from 13%-37.9%. The US has the most when compared with the OECD countries. Other studies have found out that the US has the highest rates of coronary revascularization procedures, which is a rate that doubles other countries. This study is contradicted by another, which was done indicating that there was a comparable rate of inappropriate use of coronary angiography between US and Canada. Despite this fact, a counter study that was done indicates that the inappropriate use of services in the areas studied is not dependent on the frequency of the procedure (Wolper, 2013). The net effect of the surgeries has not been studied and this being the case, it would be inappropriate to indicate that surgeries done affected quality. It should therefore be known that higher rates of surgery does not translate to negative impact but may result to boost negative and positive outcomes. Despite this fact, when a professional performs a given surgery, it would bring positive results in terms of life expectance and morbidity. On the other heart, the more the heart surgeries are done, the higher the risk of deaths as a result of medical and surgical errors in America.
Patient’s safety
Few studies have been done in relation to the patient safety. Despite this fact, the available evidence indicates that in the United States, there are greater risks of safety issues, in relation to other countries. In reference to this, the cross-national comparisons on mortality as a result of surgical and medical errors were higher in the United States than in any other country studied (Berenson & Docteur, 2013).This fact may not be held as true as the sample taken may vary. At the same time, between the comparing countries (OECD), there could be reporting errors, thus leading to the current conclusion. Other sources of information on safety indicate that out of the six countries’ evaluation of patients with high incidences of chronic illness and health care system usage, the patients in the US setting were more likely to report mistakes or gaps in expert recommendation. In this, the US reported the highest number of problems ranging from wrong medication, medical error, incorrect test results and wrong dosage among other factors (Wolper, 2013). Statistically, the issues were highest in the US (34%), while Netherlands had the lowest at 17% and Germany at 19%.
Discussion
When compared to other ten countries, the United States despite having a high cost healthcare system lags behind. The country has taken the same position from 2004 to 2014 depicting an issue that ought to be addressed. Its per capital spending on healthcare is $8508 compared to Norway, which had $5669 (Lemco, 1994). From the patient’s perspective, despite the fact that America spends more on healthcare than all its comparative countries, and has the highest proportion of physicians, its system is severely lacking. For the country to improve on the healthcare system, it will need more to access and equity to resolve the current standoff. For the overall system to improve, only accountability can aid the country. The UK, which only spent $3405, was in first place in terms of quality provision. The United Kingdom discovered its problems within the healthcare system and has been able to overcome these challenges and top the list. The government has been promoting health care providers in the leading countries by empowering more specialists into the system, giving bonuses to family physicians that function to meet targets on quality set, as well as adopting health information platforms that enable physicians and the patients to easily share information. In fact, in these countries, almost every person has a personal doctor.
America fares poorly in many aspects of the health outcomes. This is especially true because the physicians find it difficult in receiving timely information that may enable them treat diseases early. At the same time, the coordination of care is not as effective as it should be. However, not all is lost as with the financial incentives and execution of Obama care, further improvement is expected in future. Though the American system fares well in preventive and patient centered care, there exists a shortage in primary health care physicians. At the same time, the American system lacks access of primary care, especially among the minority groups and the poor. The low-income earners do not go for the needed care and therefore fail to get the recommended tests, leading to deteriorated health care. The lack of prescription at the same time leads to over the counter purchases. The net effect of this is the high infant mortality rates among the disadvantaged groups. If primary care were administered properly, mortality rates would have been controlled in America, raising the life expectance of the population.
Analysis and critique
Medical journals and other source documents indicate that the American health care system enjoys superior access to health quality care than many nations. Why then should quality in health care be compromised? Should subjective data be solely used to explain the situation in the healthcare sector? Could there be other reasons behind the ranking apart from quality? It is important to also understand the objective data that explains the underlying factors that may have contributed to the current situation ought to be studied. Factors like lifestyle, personality behaviors, heterogeneity, and culture also impact the nature of health care as well as the life expectancy and morbidity rates. These factors among others affect quality even though the medical conditions are sound.
We all agree logically that cigarette smoking and obesity are related to increased mortality rates. Even when the conditions at the health facilities are apt, behaviors of the smokers or obese people prompt other serious conditions that may reduce person’s life expectancy. Smoking alone in the US accounts for more than 443000 deaths every year. At the same time, it is important that cigarette smoking as well as obesity account to a considerable percentage of heart attacks every year. Logically speaking, even if we blamed health systems, how do cigarettes relate to these? Should we not rather be talking of behavior change among the people instead of blaming the physicians for laxity and administration hassles? It is important to note that the reported cases on quality is inclusive of these factors, and this being the case, other conditions and factors other than the medical setting conditions ought to be refocused. For instance, in regards to cancer, the US fairs badly. Does that mean that cigarette smoking does not contribute? The effects of smoking affect many other body parts and may be this could explain why surgery outcomes and other especially the heart surgery are less successful. Obesity at the same time is considered to pose greater risks of heart attack, diabetes and high blood pressure among other negative outcomes. Could this condition affect the ranking of the quality level of the healthcare in US? Of the countries ranked (OECD nations), America tops in obesity cases. At the same time, the US has a higher burden of cigarette smoking than any other country ranked. This being the case, could one authoritatively indicate that these two conditions have an impact in the outcome of the healthcare system in America?
Although research indicated that America fared poorly in cancer and heart surgery survival rates, did any research dare to compare the number of surgeries done in the comparative countries? Objectively, America has more survival cases of cancer and heart surgeries. This is objectively true because the frequency of these cases is higher than in the comparative countries. Comparatively, Americans suffering from heart disease benefit from treatment more than any other country. At the same time, there is greater reduction of deaths from heart attacks in America than in other European countries. The 2007 comparative study between the Canadians and Americans on diabetes indicated that the Americans received treatment than the Canadians.
Conclusion
Subjectively, the findings from international studies indicate that America has indeed performed poorly in comparison to other developed countries especially the European countries. This fact is contrasted by the objective observation that indicates otherwise. One fact is that it is not possible to verify the research that is done to determine if it is exhaustive or biased. One fact clear though is the fact that across the board, there is need to improve the health care system of the United States so that the life expectancy and mortality rates can be increased and reduced respectively. All in all, the various dimensions of quality health including quality, access, equity, health living and cost may not be fully accepted as the only source of measurement to compare healthcare in different cou
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