Document Detail

On the success, cost and efficiency of modern medicine: an international comparison.
MedLine Citation:
PMID:  9487326     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To study the success and cost of modern medicine in industrialized, rich countries from 1980 to 1990. DESIGN: Cost per capita and per cent of gross domestic product (GDP) spent on health was related to: (i) mortality in six diseases amenable to treatment by modern medicine; (ii) the sum of those six diseases (avoidable disease); (iii) death due to other, unavoidable diseases; (iv) maternal and infant mortality; (v) life expectancy at birth; (vi) renal dialysis and transplantation rates. Efficiency was studied by comparing a country's avoidable mortality rates multiplied by expenses, to the mean for all countries. RESULTS: During the 10 years, avoidable death rate decreased 38% but unavoidable death rate only 10%. Life expectancy increased 3%. Cost per capita increased 107% but health expenditures, as per cent of GDP only 10%. There was a reasonable correlation between expenses and avoidable mortality but none between expenses and unavoidable death rate. In 1990 avoidable mortality was lowest in Canada, and highest in Japan. Cost was lowest in New Zealand, and highest in the USA. The efficiency index was highest for Australia, and lowest in the USA. CONCLUSION: Modern medicine as we have studied it is successful. Avoidable death rate shows a steep uninterrupted decline over the last 50 years while unavoidable death rate shows only small decreases. Cost as per cent of GDP has increased only moderately. There is a correlation between expenses and mortality from avoidable but not from unavoidable diseases, and a large variation in efficiency.
C M Kjellstrand; C Kovithavongs; E Szabo
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of internal medicine     Volume:  243     ISSN:  0954-6820     ISO Abbreviation:  J. Intern. Med.     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1998-03-05     Completed Date:  1998-03-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8904841     Medline TA:  J Intern Med     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  3-14     Citation Subset:  IM    
Department of Medicine, University of Alberta, Edmonton, Canada.
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MeSH Terms
Clinical Medicine / economics*
Developed Countries / economics*,  statistics & numerical data*
Health Expenditures / statistics & numerical data*
Life Expectancy / trends
Mortality / trends
Organ Transplantation / economics,  statistics & numerical data
Renal Dialysis / economics,  statistics & numerical data

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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