It may be better to get less health care at higher quality than have low quality health care services more available.
That’s the conclusion of a study published in The Lancet. The study found that 5 million people in low- and middle-income countries die every year because of poor health care. That’s significantly more than the 3.6 million who die in those countries because of lack of health care.
According to the report:
Universal health coverage has been proposed as a strategy to improve health in low-income and middle-income countries (LMICs). However, this is contingent on the provision of good-quality health care. We estimate the excess mortality for conditions targeted in the Sustainable Development Goals (SDG) that are amenable to health care and the portion of this excess mortality due to poor-quality care in 137 LMICs, in which excess mortality refers to deaths that could have been averted in settings with strong health systems.
“For a very long time in global health, we have been really mandating and supporting and pushing access to care, without really thinking about what happens when people get to the clinic,” Dr. Margaret Kruk, the co-commissioner of this study and a professor at the Harvard T. H. Chan School of Public Health, tells NPR.
The commission that performed the study includes 30 experts in 18 countries. Kruk tells NPR the commission’s most important finding is:
There are 8.6 million deaths every year in low- and middle-income countries — the majority of the world, 134 countries — that could have been saved with good-quality health systems. These were deaths from treatable conditions because people didn’t get good care.
Of that 8.6 million, we found that 5 million were people who got care but just got poor quality care. The remaining 3.6 million were because of a lack of access, which has been the traditional focus in global health.