Lancet: China's top 13 medical accessibility and quality rankings in one year

Source: new vision of health 2018-05-25 recently, the lancet released the changes and latest ranking of medical accessibility and quality in 195 countries and regions in the world during 1990-2016 The researchers analyzed the "healthcare access and quality (HAQ)" index of these countries, and the correlation between the HAQ index and the social and demographic development index (SDI) of each country From 2000 to 2016, the world's overall HAQ index improved, in part because of greater progress in medical access and quality in many low - and middle-income countries in sub Saharan Africa and Southeast Asia In this study, the HAQ index of 195 countries and regions in the world from 1990 to 2016 was counted The index score is between 0 and 100 The score depends on the cure rate and mortality of 32 preventable and treatable diseases, including cancer, heart disease, infectious disease, maternal and infant disease, respiratory disease, etc At the same time, for the first time, the study analyzed medical access and quality in different regions of seven countries (Brazil, China, the United Kingdom, India, Japan, Mexico and the United States) Overall, in 2016, the average score of the global medical accessibility and quality index was 54.4, an increase from 42.4 in 2000 In 2016, compared with 2000, the gap between the highest score and the lowest score is still very similar In 2016, there was a gap of 78.5 between the best and the worst countries (the lowest 18.6 in the Central African Republic, the highest 97.1 in Iceland), while in 2000, the gap between the best and the worst countries was 79.3 (the lowest 13.5 in Somalia, the highest 92.8 in Iceland) In 2016, the top 5 countries in the HAQ index were Iceland (97.1), Norway (96.6), the Netherlands (96.1), Luxembourg (96.0), Finland (95.9) and Australia (95.9) The countries ranked at the bottom of the HAQ index were the Central African Republic (18.6), Somalia (19.0), Guinea Bissau (23.4), Chad (25.4) and Afghanistan (25.9) ▲ distribution map of scores of HAQ index of all countries in the world (picture source: The Lancet) from 2000 to 2016, many countries in sub Saharan Africa and Southeast Asia have made significant progress in medical access and quality, Ethiopia, Rwanda, Equatorial Guinea, Myanmar and Cambodia are the four countries with the greatest progress On the contrary, in the United States and some Latin American countries (including Puerto Rico, Panama and Mexico), the development of medical access and quality has slowed down or stagnated The HAQ index of Brazil, China, Britain, India, Japan, Mexico and the United States shows that the development imbalance of different regions in China and India is the most serious, and the regional differences of HAQ index are 43.5 and 30.8 respectively The HAQ difference in Japan is the narrowest, and the regional difference is only 4.8 China's overall situation: in 2016, China's overall score of HAQ was 77.9, ranking 48th out of 195 countries, 13 places ahead of the 61st place in 2015 (the HAQ index rose by 24.7 in the 25 years from 1990 to 2015) From 1990 to 2016, China significantly improved the HAQ index (the score increased by 35.5), especially from 2000 to 2006, and made great progress However, the unbalanced development of various regions in China is prominent: the difference between the highest and the lowest value of HAQ is 43.5 (the highest in Beijing is 91.5, the lowest in Tibet is 48.0); the HAQ index of eastern provinces is better than that of western provinces ▲ compared with middle and low-level developing countries, highly developed countries are more able to ensure the accessibility of high-quality medical services as a whole (photo source: The Lancet) In response to the report on medical accessibility and quality update released by the lancet, Dr Svetlana V doubova of the Mexican Institute of social security and other comments pointed out some of the Enlightenment: Based on the analysis of social demography (SDI), compared with the low to middle stage countries, the highly developed countries are more able to guarantee the accessibility of high-quality medical services as a whole In highly developed countries, the accessibility and quality index of medical services in all regions tend to be more balanced and consistent, matching with the overall per capita medical expenditure On the contrary, the accessibility and quality of medical services in different regions of countries in the middle and low development stage are uneven and uneven For large countries with decentralized medical system (such as Mexico and Brazil), local regional HAQ monitoring and benchmarking are of great significance Because there are many kinds of unbalanced factors in HAQ area in these countries, which seriously affect the level of health care and the accessibility of medical services Although the budget of medical expenditure in most countries has been increasing in the past decades, the ability to allocate medical resources has not been improved Therefore, there is still a question to be answered: how can we improve the efficiency of medical resource allocation? Dr doubova pointed out that the basic measures to achieve the goal of balanced full coverage of medical services for all should include: implementing a differentiated medical system in different regions within each country; inclining public policies to medical care; and integrating China's efforts to ensure the reasonable operation of the basic medical service system in the middle and low development stage "In the past, public health services focused on infectious diseases and maternal and child health care; now, the uncontrolled growth of non infectious diseases is another key service." Dr Svetlana V doubova said: "some countries in the world (such as Brazil and Colombia) have gradually shown a trend of introducing a comprehensive network of primary, secondary and tertiary hierarchical medical systems, which is conducive to increasing investment in supporting the continuity of medical services provided to patients between different medical service providers."