Global comparison of health systems: Germany only ranks 20th

Healthcare quality increased worldwide
Health care worldwide has improved significantly in recent decades, but the gap between the countries with the highest level of care and the countries with the lowest level of care has continued to widen. Germany ranks 20th in the current ranking in the "Healthcare Quality and Access Index" (HAQ index).

An international team of researchers involving hundreds of scientists worldwide has examined access to health systems and the quality of healthcare in 195 countries. Accordingly, the so-called HAQ index has risen in a large number of countries over the past 25 years. Andorra achieved the best position in the comparison of the HAQ index. Germany is in 20th place, which clearly shows that significant improvements in the quality of health care would still be possible in Germany. The results of the current study were published in the specialist magazine "The Lancet".

Health care rated in 195 states
In their study, the scientists of the "GBD 2015 Healthcare Access and Quality Collaborators" examined the quality of healthcare in 195 countries worldwide and found that the HAQ index improved in 167 of these countries between 1990 and 2015. The average HAQ index worldwide rose from 40.7 to 53.7 points in the period mentioned. Nevertheless, the difference between the highest and the lowest observed HAQ index was larger in 2015 than in 1990, the researchers report.

Mortality for certain diseases as a basis for assessment
The assessment was based on the data from the "Global Burden of Disease Study", whereby the scientists focused on mortality from certain diseases (for example tetanus, tuberculosis and various cancers) that are normally not fatal if adequately treated. According to the researchers, high mortality from these diseases is closely related to the quality of health care. However, the data collected have the weakness that many chronic diseases have not been taken into account, the scientists concede.

Health care improvements could have been greater
The countries with the greatest improvements in health care in recent decades include South Korea, Turkey, Peru, China and the Maldives, according to the researchers. Development was particularly bad in some Central African countries and Afghanistan, for example. In their study, the researchers also calculated what quality the health care of the countries could theoretically achieve at the respective level of development (socio-demographic index; SDI). “If each country had achieved the highest HAQ index based on its SDI value, the average would have been 73.8 points in 2015,” the scientists report.

There is still clear room for improvement in Germany
For Germany, the researchers calculated a theoretically achievable HAQ index of 90.7 points, although only 86.4 points were actually achieved. Although no explicit deficits are named in the study, measles, for example, are included in the pool of diseases assessed and the eradication of viruses has so far been less successful in Germany than in other countries. In any case, the assessment clearly shows that there is still room for improvement in the quality of health care in this country. (fp)

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