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U.S. Vs. The World

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The United States health care system does better in some rankings than others when compared with other developed country health care systems.

Elizabeth Docteur and Robert Berenson review the U.S. system’s standings in an analysis released by the Urban Institute, Washington.

The United States has more income inequality and more severe pockets of poverty than most other developed countries.

The United States tends rank last, or close to the bottom, on indicators such as life expectancy and infant mortality, but experts say it is not always clear whether that poor performance is due to problems with the U.S. health care or health finance systems, or a result of the effects of poverty.

One study, for example, shows that uninsured U.S. residents who had any contact with the health care system within the previous 2 years were as likely as insured residents to receive care that met professionally recommended standards of care, Docteur and Berenson write.

The United States performs relatively well in terms of whether residents have received commonly recommended diagnostic procedures, such as Pap smears and mammograms.

One study found that about 85% of U.S. adult women said they had had Pap smears within the past 2 years, and that 84% of U.S. adult women ages 50 to 64 said they had had mammograms within the past 2 years. The United States performed better according to those measures than any of the 4 other developed countries studied, Docteur and Berenson write.

The United States also has high survival rates for conditions such as uterine cancer, Hodgkins disease and melanoma, Docteur and Berenson write.

But the researchers note that the United States may have higher-than-usual cancer survival rates because broad U.S. screening programs detect many early cases of cancer that might not have been detected in other countries and might not have proved to be fatal.

“The relationship between cancer survival and level of expenditure on diagnosis has yet to be fully explored, due to data limitations,” the researchers write.

The researchers did find some efforts to compare what different countries spend on care for patients with various diagnoses.

The United States, for example, provides care with a value equal to 41% to 62% of per capita gross domestic product on the care provided during the first 6 months after a patient has been diagnosed with breast cancer, according to one study that Docteur and Berenson reviewed.

In Canada and France, a patient with breast cancer gets care with a value equal to about 33% of per capita GDP during the first 6 months after being diagnosed, the researchers write.


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