WASHINGTON France, Japan and Australia rated best and the United States worst in new rankings focusing on preventable deaths due to treatable conditions in 19 leading industrialized nations, researchers said on Tuesday.
If the U.S. health care system performed as well as those of those top three countries, there would be 101,000 fewer deaths in the United States per year, according to researchers writing in the journal Health Affairs.
Researchers Ellen Nolte and Martin McKee of the London School of Hygiene and Tropical Medicine tracked deaths that they deemed could have been prevented by access to timely and effective health care, and ranked nations on how they did.
They called such deaths an important way to gauge the performance of a country's health care system.
Nolte said the large number of Americans who lack any type of health insurance -- about 47 million people in a country of about 300 million, according to U.S. government estimates -- probably was a key factor in the poor showing of the United States compared to other industrialized nations in the study.
"I wouldn't say it (the last-place ranking) is a condemnation, because I think health care in the U.S. is pretty good if you have access. But if you don't, I think that's the main problem, isn't it?" Nolte said in a telephone interview.
In establishing their rankings, the researchers considered deaths before age 75 from numerous causes, including heart disease, stroke, certain cancers, diabetes, certain bacterial infections and complications of common surgical procedures.
Such deaths accounted for 23 percent of overall deaths in men and 32 percent of deaths in women, the researchers said.
France did best -- with 64.8 deaths deemed preventable by timely and effective health care per 100,000 people, in the study period of 2002 and 2003. Japan had 71.2 and Australia had 71.3 such deaths per 100,000 people. The United States had 109.7 such deaths per 100,000 people, the researchers said.
After the top three, Spain was fourth best, followed in order by Italy, Canada, Norway, the Netherlands, Sweden, Greece, Austria, Germany, Finland, New Zealand, Denmark, Britain, Ireland and Portugal, with the United States last.
The researchers compared these rankings with rankings for the same 19 countries covering the period of 1997 and 1998. France and Japan also were first and second in those rankings, while the United States was 15th, meaning it fell four places in the latest rankings.
All the countries made progress in reducing preventable deaths from these earlier rankings, the researchers said. These types of deaths dropped by an average of 16 percent for the nations in the study, but the U.S. decline was only 4 percent.
The research was backed by the Commonwealth Fund, a private New York-based health policy foundation.
"It is startling to see the U.S. falling even farther behind on this crucial indicator of health system performance," Commonwealth Fund Senior Vice President Cathy Schoen said.
"The fact that other countries are reducing these preventable deaths more rapidly, yet spending far less, indicates that policy, goals and efforts to improve health systems make a difference," Schoen added in a statement.
(Editing by Cynthia Osterman)