U.S. lags France, Germany, U.K. on potential preventable death rates
The United States lags three other industrialized nations — France, Germany, and the United Kingdom — in its potentially preventable death rate, and in the pace of improvement in preventing deaths that could have been avoided with timely and effective health care, according to a Commonwealth Fund-supported study published as a web first in Health Affairs. Between 1999 and 2006-2007, the overall potentially preventable death rate among men ages up to 74 dropped by only 18.5 percent in the United States, while the rate declined by nearly 37 percent in the U.K. For women, the rate fell by 17.5 percent in the U.S. but by nearly 32 percent in the U.K.
In "In Amenable Mortality — Deaths Avoidable Through Health Care — Progress In the US Lags That of Three European Countries," Ellen Nolte, director of health and health care at RAND Europe, and Martin McKee, professor of European public health at the London School of Hygiene & Tropical Medicine, analyzed amenable mortality trends. Amenable mortality is a measure of deaths before age 75 that could potentially have been prevented by timely access to appropriate health care. The research also looked at death rates for those under 65, as well as deaths between ages 65 and 74 from conditions like treatable cancer, diabetes, infections, and heart disease.
While the pace of improvement was slower in the U.S. for both age groups, the lag was most pronounced among American men and women under age 65, who are more likely to be uninsured and have problems with access to care than those 65 and older, who are eligible for Medicare. By comparison, France, Germany and the U.K. all provide affordable, universal coverage to their populations regardless of age. "These findings strengthen the case for reforms that will enable all Americans to receive timely and effective health care" said Nolte, lead author of the study.
By 2007, the potentially preventable death rate among U.S. men under age 65 was 69 per 100,000, considerably higher than in the U.K. (53), Germany, (50) and France (37). Death rates for men in this age group have declined more rapidly in all three countries since 1999 than in the United States.
Among women under age 65, the potentially preventable death rate dropped from 64 to 56 per 100,000 in the U.S., from 61 to 46 per 100,000 in the U.K., from 49 to 40 per 100,000 in Germany, and from 42 to 34 per 100,000 in France. For both women and men under age 65, U.S. potentially preventable death rates were higher than the other three countries.
In contrast to the under-65 population, U.S. potentially preventable death rates compared relatively well for men and women ages 65-74, the age when people in the U.S. become eligible for Medicare. However, the U.S. rate of decline in this age group was slower than that in the U.K. and Germany.
"Despite spending about twice as much per person each year on health care as France, Germany or the U.K.— $8,400 in 2010—the U.S. is increasingly falling behind these countries in terms of progress in lowering the potentially preventable death rate," said Commonwealth Fund President Karen Davis. "The good news is that the Affordable Care Act is already beginning to close the gaps in access to care. When fully implemented, it will cover nearly all Americans, with the potential to put our country on track to improve to levels seen in the best-performing countries."
A summary of the article is available on the Commonwealth Fund Web, http://www.commonwealthfund.org/Publications/In-the-Literature/2012/Aug/Variations-Amenable-Mortality.aspx.