The Problem With Ranking Countries’ Health-Care Systems

The oft-cited WHO ranking that said the U.S. has the 37th best health-care system in the world is dated and had problems even when it was new, WSJ stats maven Carl Bialik writesin his column today.

The ranking was published in 2000, and came up against a major problem: Good data weren’t available from many countries. So researchers used other measures, such as literacy rates and income inequality, to infer health data. The report’s editor in chief later called the findings “spurious” noting the lack of solid data.

Still, it’s worth noting that the U.S. doesn’t fare particularly well on some measures where there are good data — we’re 24th in the world in male life expectancy and 35th in the world in female life expectancy, Bialik notes.

At the same time, life expectancy is a product of many factors — not only the quality of a nation’s medical care, but also issues such as nutrition, smoking rates and the like.

When the Law Allows Hospital Errors to Remain Secret

Connecticut law requires hospitals to tell the state Department of Public Health when certain medical errors harm patients. But some tweaks that were made to the law five years ago mean that hospitals report far fewer incidents, and those incidents that are reported are often kept secret from the public, the Hartford Courant reports.

Connecticut adopted “adverse event” legislation in 2002, a few years after the Institute of Medicine published its influential “To Err is Human” report that said as many as 98,000 people die every year in U.S. hospitals due to human error.

But Connecticut hospitals complained about the reports that were starting to be made public, the Courant says. In 2004, revisions to the law limited the types of events that need to be reported and said the data filed by the hospitals would stay secret unless they prompted an investigation.

Since the redrafting, the paper says, public access to hospitals’ adverse events reports has fallen 90%. In each of the last five years, between 228 and 247 reports have been made under the new law, resulting in about 60 investigations each year.

“The details of more than a dozen sexual assaults are concealed in the health department’s files, along with at least 30 cases in which sponges or other objects were left in patients’ bodies after surgery,” the paper said based on its analysis.

Hospital spokespeople quoted in the article say their institutions understand and follow the law’s provisions . One said “questionable cases” were reviewed by her hospital’s senior management and sent on to the state if they meet the reporting criteria.

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