France tops global healthcare study

France has the best healthcare system in the world, followed by Italy, while Sierra Leone has the worst, according to a contentious first attempt to rank the world's health systems.

The US, which spends more on healthcare than any other nation, came in 37th.

In the analysis published Wednesday, the World Health Organization (WHO) evaluated the healthcare systems of its 191 members and graded them based on how well each country performs given its resources.

Previous assessments have looked just at how healthy people are, "and you're left with the image that the rich (countries) do well because they're rich," said study co-author Dr. Julio Frenk. This new analysis praises systems utilizing "few resources very well."

The report essentially measures value for money: comparing a population's health with how effectively governments spend their money on health, illness prevention, and how fairly minorities and the poor are treated.

Dr. Christopher Murray, a Harvard health economist and the health organization's chief of health policy had expected Scandinavian countries or Canada to be the world's best, because they're always presented as models. Instead, Norway hit No. 11, Canada 30.

Some health economists raised concerns about the method used to compile the rankings, in which several Mediterranean countries scored unexpectedly high. Tiny countries with few patients to care for - San Marino, Andorra, Malta - crowd the top spots.

Some experts contended the rankings say more about the health of people in each country rather than the quality of the healthcare systems. "They are obviously getting an olive oil effect," said Nick Bosanquet, health policy professor at London University's Imperial College, referring to the reported health benefits of the Mediterranean diet.

- Associated Press

(c) Copyright 2000. The Christian Science Publishing Society

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