WASHINGTON, May 4 (UPI) -- It is common to hear people say the United States has the best healthcare in the world -- it just might not be entirely accurate.
A study published Tuesday in the journal Health Affairs puts a giant asterisk at the end of that statement through the first international comparison of key healthcare quality indicators. The Commonwealth Fund, a non-profit research organization in New York, funded the study.
The data -- which the authors said should serve as a wakeup call for the U.S. healthcare industry and government -- covers Australia, Canada, England, New Zealand and the United States on 21 key measures -- including outcome indicators that rate survival, outcome indicators that look at avoidable events, and process indicators, such as breast cancer screening or tomography.
"None of the five countries is consistently the best or the worst on all 21 indicators," said Gerard Anderson, a lead researcher from Johns Hopkins University in Baltimore. "So if you're looking for the place to go to get the best care, there isn't a single place, you've got to be selective."
Anderson told a teleconference briefing that although Australia has the best rates of breast cancer screening, it ranks the worst for five-year survival of childhood leukemia. Canada has the best ranking for five-year survival of kidney and liver transplant patients, but is the worst for 30-day heart attack survival.
England is tops in having the lowest incidence of suicide but also lowest in five-year survival rates for breast cancer. New Zealand's five-year colorectal scan rate is the highest among the five countries, but so is its suicide rate -- especially for young people.
The United States, which spends almost twice as much as the other countries on healthcare each year, has the best five-year breast cancer survival rates, but the worst kidney transplant survival rate over the same period.
"It's clear that there isn't any country that has emerged as having the best care," said Dr. John Millar, of British Columbia's Provincial Health Services Authority. He said the study also suggests the need for countries to invest more in information systems to monitor quality indicators.
Millar said some countries, such as Britain and New Zealand, already are working on areas where they attained low rankings.
DRUG PATENTS NOT THE BIG ISSUE
It's poverty, not patents, that restricts access to drugs in developing countries, Amir Attaran, a lawyer and immunologist told UPI's HealthBiz Tuesday.
The debate has been between pharmaceutical interests arguing in favor of drug patents in developing countries, he said, and activists arguing more should be done to make vital medications available cheaply, if not freely, to needy areas.
Attaran, a fellow in the Royal Institute of International Affairs in London and a principal with Idealith Research in Cambridge, Mass., has a study -- also in this week's Health Affairs -- entitled "How Do Patents and Economic Policies Affect Access to Essential Medicines in Developing Countries?"
Attaran looked at the relationship between patents and access to essential medicines in 65 low-income and middle-income countries. It was based on 319 products on the World Health Organization's Model List of Essential Medicines.
He found in those 65 countries -- with a combined population of about 4 billion -- patents are rare for the 319 products on the WHO list. Only 17 of so-called essential medicines are even legally patentable, he said.
International law and agreements, he said, call developing countries to hold off, if they wish, offering patents until 2016 and there has been debate about whether that would be a "catastrophic watershed" moment for those countries in terms of getting needed medications.
"This watershed is not in the future," Attaran said. "It's behind us and nobody notices."
Of those least-developed countries, 28 quietly put pharmaceutical patent laws in place in the 1980s and 1990s.
He said he hopes the data from his study will "take some of the venom out of the debate" over patents in developing countries.
"Most of the lack of patenting is explained by the fact that even where patent laws existed for years, the pharmaceutical companies didn't bother to use them in the developing countries," he said.
He called on pharmaceutical companies to give up patent rights to those 17 drugs and for the United States and the rest of the developed world to promote economic growth to pump more money into those countries.
QUALITY CARE TOP OECD ISSUE
The Organization for Economic Cooperation and Development meets next week and quality healthcare is a top issue.
Peter Scherer of the OECD, in reacting to the Commonwealth Fund study in Health Affairs, said other countries are developing quality frameworks. France recently worked quality of care into public health legislation and Nordic countries are setting up ways to compare their similar healthcare systems.
"The example that has come from this exercise has really inspired other countries with diverse healthcare systems" to look at quality indicators, he said.
A total 21 countries are jointly looking at 20 indicators and "trying to finalize a report based on those 20 indicators covering those wider variety of countries," he said
HOSPITAL ECONOMICS 101
The American Hospital Association's annual meeting is this week in Washington and these thousand or so hospital executives and employees make up one of the most effective, if short-tenured, lobby groups on Capitol Hill during their one-day lawmaker blitz.
The AHA used a news conference, however, to talk about a TrendWatch report from the Lewin Group showing the economic impact hospitals have in America. Hospitals, the report finds:
-- employ 5 million people,
-- rank second as a provider of private sector jobs,
-- directly or indirectly support one of every nine U.S. jobs,
-- have stable employment in good economic times and bad, and
-- purchase goods and services needed to provide care, supporting other vendors and U.S. companies.
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