Healthcare Quality Comparisons (06-17-2004) 

How Does The Quality Of Health Care Compare In Five Countries?

The Commonwealth Fund International Working Group on Quality Indicators collected data on 21 indicators that reflect medical care in Australia, Canada, New Zealand, England, and the United States. The indicators include: five-year cancer relative survival rates; thirty-day case-fatality rates after acute myocardial infarction and stroke; breast cancer screening rates and asthma mortality rates. None of the five countries emerges as a "winner" or "looser" as no one country consistently scores the best (or worse) on all of the indicators.

Here is a snapshot of how the countries fared:


Suicide rates were notably lower in England than in the other four countries. The polio vaccination rate there was the highest. However, cancer survival rates were lowest in England, as were breast and cervical cancer screening rates.


Cancer survival rates were generally average or above average and were highest for childhood leukemia. Stroke case-fatality rates were relatively low. Transplant survival was also relatively high in Canada. Smoking rates (% in population) were the lowest in Canada and the U.S.

New Zealand

The improvement in asthma mortality over the past twenty years is a true success story, although there may be room for further improvement. The colorectal cancer relative survival rate was highest. However, the suicide rate in New Zealand, particularly among younger people, was much higher than elsewhere.

United States

Breast cancer survival rates were higher than in the other countries. Cervical cancer screening rates were very high. One area for concern is that asthma mortality rates were increasing in the United States but decreasing in the other countries. Transplant survival rates were also relatively low in the United States. On average the US spends twice as much as Canada and UK in terms of percentage of Gross National Product for Health Care (14% vs. 7%). he question arises what the extra spending on health care in the US compared to the other four countries has bought. The only factor this study could point to is shorter waits for non-urgent surgery.


Cancer survival rates were generally high (excepting childhood leukemia); breast cancer screening rates were high; asthma mortality was relative low and influenza and polio vaccination rates were high. However, the incidence of pertussis was much higher than elsewhere, suggesting an opportunity for improvement.

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