OECD healthcare report shows big quality variation


WASHINGTON (Reuters), Nov 14 - Death rates from heart attacks have plummeted for people who get to hospitals, but many countries still have trouble treating and preventing chronic diseases, the Organisation for Economic Cooperation and Development reported on Tuesday.

Among the countries struggling to provide quality healthcare is the U.S., which spends far more per capita than any other OECD member but does not always deliver the best care, the OECD said.

The OECD compared various measures of healthcare across its 30 members and found large variations. But there was also some good news.

Only 10% of people hospitalized after a heart attack now die within 30 days of being admitted to hospital, down from 20% in the 1980s, the report found.

Specialist stroke units that can quickly diagnose strokes and deliver clot-dissolving treatments have brought death rates from stroke down to 10% on average.

But there was a large range. In New Zealand and Australia, only 5% to 6% of people admitted for a heart attack died in hospital within 30 days, but in Mexico 60% of those hospitalized for heart attacks died.

The OECD report found big differences in spending among its members.

The U.S. spends far more than any other country on healthcare at $6,401 per person per year in 2005, public and private spending included. Luxembourg came next at $5,352, followed by Norway at $4,364. Turkey spent the least at $586. The average was $2,759.

"Though countries with higher GDP (gross domestic product) tend to spend more on health, there is a wide variation," the OECD said in a statement.

"For example, Japan and Germany have the same GDP per capita but their health spending per capita differs considerably, with Japan spending 25% less than Germany."

Not longer or healthier

And the higher spending does not always translate to longer or healthier lives.

Cancer, the second-leading cause of death after heart disease, accounted for 27% of all deaths on average in 2004.

The average death rate for all OECD countries was 227 per 100,000 people per year. It ranged from 176 deaths per 100,000 population in Iceland to 346 in Hungary. The U.S. scored 203, Japan 208, and Britain 214.

Americans by far had the most coronary angioplasties, a procedure to clear out clogged arteries, with 433 per 100,000 population in 2004. Only two such operations were done for every 100,000 people in Mexico.

The OECD average was 249.

Death rates from heart disease ranged from 19.5 per 100,000 women and 42 per 100,000 men per year in Japan to 215 per 100,000 women and 315 per 100,000 men in the Slovak Republic.

France, South Korea, and Spain also had among the lowest rates while the U.S. was among the worst countries for deaths from heart disease at 94 per 100,000 women and 170 per 100,000 men.

Australia, Canada, and Britain all scored nearer the average.

The U.S. also scored poorly for infant mortality rates, which ranged from a low of two to three deaths per 1,000 live births in Japan, Sweden, and Norway to 24 deaths per 1,000 live births in Turkey. The U.S. had six6 deaths per 1,000 live births, higher than the 5.4 average for OECD countries.

By Maggie Fox

Last Updated: 2007-11-14 11:05:29 -0400 (Reuters Health)

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