POST TIME: 10 September, 2018 00:00 00 AM
Poor health care linked to five million deaths worldwide a year

Poor health care linked 
to five million deaths 
worldwide a year

Poor-quality health care results in about 5 million deaths a year in low- and middle-income countries, new research suggests. And another 3.6 million deaths a year are caused by lack of access to care, the study found. "Quality care should not be the purview of the elite, or an aspiration for some distant future; it should be the DNA of all health systems," said Dr. Margaret Kruk, who chaired the commission that conducted the report.

"Given our findings, it is not surprising that only one-quarter of people in low- and middle-income countries believe that their health systems work well," added Kruk, who is from the Harvard School of Public Health.

While many of these countries have made significant progress in improving access to care, the researchers said the findings show that poor-quality care now causes more deaths than poor access to care.

The number of deaths worldwide each year from poor-quality care is five times higher than the number of deaths from HIV/AIDS (1 million), and more than three times higher than deaths from diabetes (1.4 million), according to the study published Sept. 5 in The Lancet Public Health journal.

Poor-quality care is a major cause of deaths from treatable conditions, including 84 per cent of cardiovascular deaths, 81 per cent of vaccine preventable diseases, 61 per cent of neonatal conditions, and half of maternal, road injury, tuberculosis, HIV and other infectious disease deaths, the researchers said.

Poor access to care was a proportionally greater factor in deaths from cancer (89 per cent), mental and neurological conditions (85 per cent), and chronic respiratory conditions (76 per cent).

The study was conducted as part of the journal's Global Health Commission on High Quality Health Systems, a two-year project in which 30 academics, policymakers and health experts from 18 countries examined how to measure and improve health system quality worldwide. "The human right to health is meaningless without good-quality care. High-quality health systems put people first," Kruk said in a journal news release. "The impact of poor-quality care goes well beyond mortality, but can lead to unnecessary suffering, persistent symptoms, loss of function, and a lack of trust in the health system," she said.

Poor quality health services are holding back progress on improving health in countries at all income levels, according to a new joint report by the OECD, World Health Organization (WHO) and the World Bank.

Today, inaccurate diagnosis, medication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training and expertise prevail in all countries.

The situation is worst in low and middle-income countries where 10 per cent of hospitalized patients can expect to acquire an infection during their stay, as compared to seven per cent in high income countries. This is despite hospital acquired infections being easily avoided through better hygiene, improved infection control practices and appropriate use of antimicrobials.. At the same time, one in ten patients is harmed during medical treatment in high income countries.

These are just some of the highlights from Delivering Quality Health Services – a Global Imperative for Universal Health Coverage. The report also highlights that sickness associated with poor quality health care imposes additional expenditure on families and health systems.  There has been some progress in improving quality, for example in survival rates for cancer and cardiovascular disease. Even so, the broader economic and social costs of poor quality care, including long-term disability, impairment and lost productivity, are estimated to amount to trillions of dollars each year.