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creening rate and the lowest smoking rate. For breast cancer survival rates, the United States (86%) was 11 percentage points better than the worst country, which was the United Kingdom. For cervical cancer screening, the United States (93%) was 26 percentage points better than the United Kingdom, the worst country. The United States tied with Canada for having the lowest smoking rate, which was 15 percent lower than the lowest country, which was the United Kingdom. The United States performed more poorly on indicators including asthma mortality rates and survival after kidney and liver transplants. The United States is the only country where asthma mortality rates have been increasing over time; they are now higher than in the United Kingdom and Australia. The survival rate after kidney transplant in the United States (83%) was 11 percentage points lower than in Canada, the country with the highest rate.

One noteworthy pattern was the United Kingdom. It was the lowest country in five of the nine survival rate indicators and highest in five of the eight avoidable event indicators meaning the United Kingdom is exceptional at preventing avoidable health issues like contracting pertussis or hepatitis B, but has the lowest cancer survival rate of the five countries studied.

"Each country in our study has areas of care where it can learn from the other countries and areas where it could teach others. That tells us that there are opportunities for improvement in the quality of health care in all five countries. We hope our study will be expanded upon so that it can be used to judge overall health system performance around the world," Hussey said. He also noted that Americans were spending more on healthcare, but not receiving extra benefits or having better health care experiences.

Hussey, and colleague Gerard F. Anderson, PhD, a professor of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, also co-wrote a seco
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Contact: Kenna L. Brigham
paffairs@jhsph.edu
410-955-6878
Johns Hopkins University Bloomberg School of Public Health
4-May-2004

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