According to the World Health Organization’s (WHO) 2000 report, the U.S. ranked 37th in the world in terms of the quality of its health care system. The placed the U.S. health system behind Saudi Arabia, Costa Rica and Morocco. Do we need to fire all U.S. doctors? Should everyone stop reading this blog post and immediately go for a run or eat a tofu salad?
In a letter to the New England Journal of Medicine, Dr. Philip Musgrove, the former editor of the WHO report recounts the unreliable data used to rank country health systems. In the case of the United States, the only data available were for life expectancy and child survival, which together only account for about half of the the attainment measure. Thus, the rest of the figures in the U.S. figures had to be imputed. In fact, the values of for many variables for many countries had to be imputed. With such an indictment for the editor of this report, putting much value in these rankings seems dubious. According to Dr. Musgrove:
“The number 37 is meaningless, but it continues to be cited, for four reasons. First, people would like to trust the WHO and presume that the organization must know what it is talking about. Second, very few people are aware of the reason why in this case that trust is misplaced, partly because the explanation was published 3 years after the report containing the ranking. Third, numbers confer a spurious precision, appealing even to people who have no idea where the numbers came from. Finally, those persons responsible for the number continue to peddle it anyway…Analyzing the failings of health systems can be valuable; making up rankings among them is not. It is long past time for this zombie number to disappear from circulation.”
- HT: GoozNews.