How Does the Quality of Health Care Compare Internationally?
Elizabeth Docteur Consulting
Robert A. Berenson
The Urban Institute
August 24, 2009
Timely Analysis of Immediate Health Policy Issues, a series of policy briefs produced by the Urban Institute and the Robert Wood Johnson Foundation
There is a perception among many Americans that despite coverage, cost and other problems in the health care system, the quality of health care in the United States is better than it is anywhere else in the world and might be threatened by health reform. This paper investigates available evidence on how quality of care in the United States compares to that of other countries and comments on the implications for the health reform debate. Taken collectively, the findings from international studies of health care quality do not support the oft-repeated claim that the "U.S. health care is the best in the world." In fact, there is no hard evidence of particular areas in which U.S. health care is truly exceptional. Instead, the picture that emerges from a review of the evidence on health system performance is a mixed bag, with the United States doing relatively well in some areas --- such as cancer care --- and less well in others --- such as mortality from conditions amenable to prevention and treatment. The argument that reform of the U.S. health system stands to endanger "the best health care in the world" lacks foundation. Like other countries, the United States has both strengths and weaknesses in terms of the quality of care available, and the quality of care the population receives. The main ways in which the United States differs from other developed countries are in the very high costs of its health care and the share of the population that is uninsured. Assertions of excellence divert attention from the need to inspire and foster systematic quality improvement activities. Health reform can be seen as an opportunity to improve quality of care by building on strengths and correcting weaknesses, rather than as a threat.
Number of Pages in PDF File: 14
Keywords: health care, quality, United States, value, reform, amenable mortality, outcomes
JEL Classification: I11, I18working papers series
Date posted: October 6, 2009
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