Home > Uncategorized > Irish health system is ‘most efficient’ in world

Irish health system is ‘most efficient’ in world

Here’s a remarkable story, via The Guardian. It seems to have not been reported in the press here at all (at least I haven’t found a reference to it).  I wonder why the HSE hasn’t been all over it?

The NHS is one of the most cost-effective health systems in the developed world, according to a study (pdf) published in the Journal of the Royal Society of Medicine.

The “surprising” findings show the NHS saving more lives for each pound spent as a proportion of national wealth than any other country apart from Ireland over 25 years. Among the 17 countries considered, the United States healthcare system was among the least efficient and effective. [emphasis added]

Here’s the paper. And below is the abstract:

Comparing the USA, UK and 17 Western countries’ efficiency and effectiveness in reducing mortality

Colin Pritchard1 and Mark S Wallace2

1School of Health & Social Care, Bournemouth University, Bournemouth, UK
2Department of Economics, Latymer School, London, UK

Correspondence to: Colin Pritchard. Email: cpritchard@bournemouth.ac.uk


Objectives To test the hypothesis that the USA healthcare system was superior to the NHS and 17 other Western countries in reducing feasible mortality rates over the period 1979–2005.

Design Economic inputs into healthcare, GDP health expenditure (GDPHE) were compared with clinical outputs, i.e. total ‘adult’ (15–74 years) and ‘older’ (55–74 years) mortality rates based upon three-year average mortality rates for 1979–81 vs. 2003–2005. A cost-effective ratio was calculated by dividing average GDPHE into reduced mortality rates over the period.

Setting Nineteen Western countries’ mortality rates compared between 1979–2005.

Participants Mortality of people by age and gender.

Main outcome measures A cost-effective ratio to measure efficiency and effectiveness of healthcare systems in reducing mortality rates. Chi-square tested any differences between the USA, UK and other Western countries.

Results Input: The USA had the highest current and average GDPHE; the UK was 10th highest but joint 16th overall, still below the Western countries’ average. Output: Every country’s mortality rate fell substantially; but 15 countries reduced their mortality rates significantly more than the US, while UK ‘adult’ and ‘older’ mortality rates fell significantly more than 12 other countries. Cost-effectiveness: The USA GDPHE: mortality rate ratio was 1:205 for ‘adults’ and 1:515 for ‘older’ people, 16 Western countries having bigger ratios than the US; the UK had second greatest ratios at 1:593 and 1:1595, respectively. The UK ratios were >20% larger than 14 other countries.

Conclusions In cost-effective terms, i.e. economic input versus clinical output, the USA healthcare system was one of the least cost-effective in reducing mortality rates whereas the UK was one of the most cost-effective over the period.

© 2011 Royal Society of Medicine Press

Categories: Uncategorized
  1. Cathyby
    August 16, 2011 at 10:01 am

    Was surprised myself it didn’t get mentioned on twitter. It even got a hat-tip from PZ Meyers in his blog.

    I think one factor might be that it doesn’t tally with our intuitions about the service we get. But it should be noted that at the start and at the end of the study we paid the lowest proportion of GDP to health among the countries featured.

    It also clashes with the perception of waste in the HSE. However the time period covers 30 years. This study isn’t necessarily a vote of confidence for the HSE, it’s entirely plausible we might have done better in the first twenty years only to have the average come down in the last ten.

    The details need a closer look before we can really conclude anything about Ireland specifically. Looks bad for the US though.

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