USA Child (0-4) and Adult (55-74) Mortality and % GDP-Health Expenditure and the Other Western Countries 1989-2015. America needs an "National Neighbourhood Health Service"

• Main Authors: Colin Pritchard (Author), Emily Rosenorn-Lanng (Author), Richard Williams (Author)
• Format: Book
• Published: Archives of Community Medicine and Public Health - Peertechz Publications, 2019-02-12.
• Subjects: Research Article
• Online Access: Connect to this object online.

<p>Purpose: To analyse how effective was the USA, compared to Other Western Countries (OWC) in reducing premature deaths 1989-2015. </p><p>Design: This population-based study is a cost-effective model of fiscal input into health related to clinical outputs, recognising socio-economic factors influence health outcomes. Using World Bank data for total % GDP-Expenditure-on-Health, and, WHO data for Child (0-4), Adult (55-74) and Age-Standardised-Death-Rates rates per million America is compared with OWC. Cost-Effective Ratios (CEF) are calculated and Confidence Intervals (95%) tests USA against each OWC. `Excess' deaths are calculated between the most and least expensive health systems. </p><p>Setting: Twenty Other Western countries.</p><p>Patients: National populations.</p><p>Outcomes: USA highest current total %GDPEH 16.8% and highest average of 12.7% and UK lowest 7.1% over period.</p><p>USA Child (0-4) highest at 1249pm, OWC averaged 803pm. Fourteen countries had significantly bigger reductions than America. </p><p>USA Adult (55-74) mortality was highest at 12,554pm, OWC averaged 9,835pm. Fourteen countries had significantly bigger reductions than USA. </p><p>Excess Deaths: America failed to match UK total mortality rates yielding 488,273 excess deaths, of which 12,613 were children. </p><p>Cost-Effectiveness-Ratio: America had smallest CER 1:113, OWC averaged 1:270, an USA to OWC ratio of 1:239. UK CER was 1:323 producing a USA: UK ratio of 1:2.86. </p><p>Conclusion: America's health system more expensive as Britain's and significantly less effective than most OWC. 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