World Health Organization ranking of health systems

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The World Health Organization (WHO) ranked the health systems of its 191 member states in its World Health Report 2000. It provided a framework and measurement approach to examine and compare aspects of health systems around the world.[1] It developed a series of performance indicators to assess the overall level and distribution of health in the populations, and the responsiveness and financing of health care services. It was the organization's first ever analysis of the world's health systems.[2]

Contents

Ranking[edit]

RankingCountryExpenditure Per Capita
1France France4
2Italy Italy11
3San Marino San Marino21
4 Andorra23
5 Malta37
6Singapore Singapore38
7Spain Spain24
8Oman Oman62
9 Austria6
10Japan Japan13
11 Norway16
12Portugal Portugal27
13 Monaco12
14 Greece30
15Iceland Iceland14
16 Luxembourg5
17Netherlands Netherlands9
18United Kingdom United Kingdom26
19Republic of Ireland Ireland25
20Switzerland Switzerland2
21 Belgium15
22Colombia Colombia49
23Sweden Sweden7
24Cyprus Cyprus39
25Germany Germany3
26Saudi Arabia Saudi Arabia63
27United Arab Emirates United Arab Emirates35
28Israel Israel19
29Morocco Morocco99
30Canada Canada10
31Finland Finland18
32Australia Australia17
33 Chile44
34Argentina Argentina15
35 Denmark8
36 Dominica70
37Costa Rica Costa Rica50
38United States United States1
39Slovenia Slovenia29
40Cuba Cuba118
41 Brunei32
42New Zealand New Zealand20
43 Bahrain48
44 Croatia56
45Qatar Qatar27
46 Kuwait41
47 Barbados36
48Thailand Thailand64
49Czech Republic Czech Republic40
50Malaysia Malaysia93
51Poland Poland58
52 Dominican Republic92
53 Tunisia79
54 Jamaica89
55Venezuela Venezuela68
56 Albania149
57 Seychelles52
58Paraguay Paraguay91
59South Korea South Korea31
60Senegal Senegal143
61Philippines Philippines124
62Mexico Mexico55
63 Slovakia45
64Egypt Egypt115
65Kazakhstan Kazakhstan112
66 Uruguay33
67 Hungary59
68Trinidad and Tobago Trinidad and Tobago65
69 Saint Lucia86
70 Belize88
71Turkey Turkey82
72 Nicaragua104
73 Belarus74
74 Lithuania71
75 Saint Vincent and the Grenadines90
76Sri Lanka Sri Lanka138
77Estonia Estonia60
78 Guatemala130
79Ukraine Ukraine111
80 Solomon Islands134
81Algeria Algeria114
82 Palau47
83Jordan Jordan98
84 Mauritius69
85 Grenada67
86Antigua and Barbuda Antigua and Barbuda43
87Libya Libya84
88Bangladesh Bangladesh144
89 Macedonia106
90 Bosnia-Herzegovina105
91 Lebanon46
92Indonesia Indonesia154
93Iran Iran94
94 Bahamas22
95 Panama53
96 Fiji87
97 Benin171
98 Nauru42
99Romania Romania107
100 Saint Kitts and Nevis51
101 Moldova
102Bulgaria Bulgaria
103Iraq Iraq
104 Armenia
105 Latvia
106 Yugoslavia
107 Cook Islands
108Syria Syria
109 Azerbaijan
110 Suriname
111 Ecuador
112India India
113Cape Verde Cape Verde
114Georgia (country) Georgia
115 El Salvador
116 Tonga
117Uzbekistan Uzbekistan
118Comoros Comoros
119 Samoa
120Yemen Yemen
121 Niue
122Pakistan Pakistan
123 Federated States of Micronesia
124 Bhutan
125Brazil Brazil
126Bolivia Bolivia
127 Vanuatu
128 Guyana
129 Peru
130Russia Russia
131 Honduras
132 Burkina Faso
133 Sao Tome and Principe
134Sudan Sudan
135Ghana Ghana
136 Tuvalu
137 Ivory Coast
138Haiti Haiti
139 Gabon
140Kenya Kenya
141 Marshall Islands
142 Kiribati
143 Burundi
144China People's Republic of China
145 Mongolia
146 Gambia
147 Maldives
148 Papua New Guinea
149Uganda Uganda
150Nepal Nepal
151Kyrgyzstan Kyrgyzstan
152 Togo
153Turkmenistan Turkmenistan
154Tajikistan Tajikistan
155Zimbabwe Zimbabwe
156Tanzania Tanzania
157 Djibouti
158Eritrea Eritrea
159 Madagascar
160Vietnam Vietnam
161 Guinea
162Mauritania Mauritania
163Mali Mali
164 Cameroon
165Laos Laos
166 Congo
167North Korea North Korea
168 Namibia
169 Botswana
170Niger Niger
171 Equatorial Guinea
172 Rwanda
173Afghanistan Afghanistan
174Cambodia Cambodia
175South Africa South Africa
176 Guinea-Bissau
177 Swaziland
178 Chad
179 Somalia
180Ethiopia Ethiopia
181 Angola
182 Zambia
183 Lesotho
184 Mozambique
185 Malawi
186 Liberia
187Nigeria Nigeria
188Democratic Republic of the Congo Democratic Republic of the Congo
189 Central African Republic
190Myanmar Burma

Methodology[edit]

The rankings are based on an index of five factors:[1]

Criticism[edit]

The WHO rankings have been subject to criticism concerning their methodology, scientificity, and usefulness. Dr Philip Musgrove wrote that the rankings are meaningless because they oversimplify: "numbers confer a spurious precision".[3]

Journalist John Stossel notes that the use of life expectancy figures is misleading and the life expectancy in the United States is held down by homicides, accidents, poor diet, and lack of exercise. When controlled for these facts, Stossel claims that American life expectancy is actually one of the highest in the world.[4] A publication by the Pacific Research Institute in 2006 claims to have found that Americans outlive people in every other Western country, when controlled for homicides and car accidents.[5] Stossel also criticizes the ranking for favoring socialized healthcare, noting that "a country with high-quality care overall but 'unequal distribution' would rank below a country with lower quality care but equal distribution."[4]

However, another study on the effects of firearms on life expectancy by Jean Lemaire [6] of the Wharton School concluded that only 0.28 years of the 2.29 life expectancy gap between the US (76.9 years) and the other 33 richest countries (79.19 years) can be attributed to firearm deaths. The author also points out that this conclusion does not calculate for a substitution effect. Some successful firearm suicides might have used other means in the absence of firearms. Though other methods of suicide are not as effective as firearms, they cannot be expected to have been zero. Therefore, simply adjusting a life expectancy calculation by subtracting all suicides due to firearms will tend to overstate average life expectancy.

Glen Whitman claims that "it looks an awful lot like someone cherry-picked the results to make the U.S.'s relative performance look worse than it is." He also notes that the rankings favor countries where individuals or families spend little of their income directly on health care.[7] In an article in The American Spectator, Whitman notes how the rankings favor government intervention, which has nothing to do with quality of care. The rankings assume literacy rate is indicative of healthcare, but ignore many factors, such as tobacco use, nutrition, and luck. Regarding the distribution factors, Whitman says "neither measures healthcare performance" since a "healthcare system [can be] characterized by both extensive inequality and good care for everyone." If healthcare improves for one group, but remains the same for the rest of the population, that would mean an increase in inequality, despite there being an improvement in quality.[8] Dr Fessler echoed these sentiments.[9]

See also[edit]

References[edit]

  1. ^ a b World Health Organization. World Health Report 2000. Geneva, 2000.
  2. ^ World Health Organization Assesses the World's Health Systems.
  3. ^ Musgrove, P (2010). "Health Care System Rankings". New England Journal of Medicine 362 (16): 1546–7; author reply 1547. doi:10.1056/NEJMc1001849. PMID 20410524. 
  4. ^ a b Stossel, John (22 August 2007). "Why the U.S. Ranks Low on WHO's Health-Care Study". Real Clear Politics. Creators Syndicate. Retrieved 29 September 2011. 
  5. ^ Pipes, Sally C. (October 2008). "Top Ten Myths of American Health Care". Pacific Research Institute. p. 133. Retrieved 1 October 2011. [unreliable source?]
  6. ^ Lemaire, Jean. "The Impact of Firearm Deaths on Life Expectancies in the United States". Retrieved 16August 2012. 
  7. ^ Whitman, Glen (1 July 2007). "WHO's Healthcare Rankings, Part 1". Agoraphilia. Blogspot. Retrieved 29 September 2011. 
  8. ^ Whitman, Glen (10 March 2008). "WHOm Are They Kidding?". The American Spectator. Retrieved 29 September 2011. 
  9. ^ Fessler, Richard G., MD, PhD (1 June 2009). "Popular Ranking Unfairly Misrepresents the U.S. Health Care System". Smart Girl Nation. Archived from the original on 22 August 2010. Retrieved 30 September 2011. [self-published source?]

External links[edit]