"Drawing from methods established in GBD 2015,20 our analysis involved four steps: mapping the Nolte and McKee cause list to GBD causes; constructing MIRs for cancers and risk-standardising non-cancer deaths to remove variations in mortality not directly amenable to health care; calculating the HAQ Index on the basis of principal components analysis (PCA), providing an overall score of personal health-care access and quality on a scale of 0–100; and examining associations between national HAQ Index scores and potential correlates of performance."Our study draws from GBD 2016 results,31–33 which entail several improvements since GBD 2015, including 169 new country-years of vital…
Healthcare Access and Quality Index: Summary of Results
"Amid gains on personal health-care access and quality, striking disparities remained regarding HAQ Index scores achieved by 2016, and how quickly locations improved over time. In 2016, HAQ Index performance diverged along the development spectrum, ranging from more than 97 in Iceland to less than 20 in the Central African Republic and Somalia. Subnational inequalities were particularly pronounced in China and India, although high-income countries, including England and the USA, also saw considerable local gaps in performance. The global pace of progress accelerated from 2000 to 2016, a trend fuelled by many low-SDI and low-middle-SDI countries in sub-Saharan Africa and…
Healthcare Access and Quality Index: Limitations
"Our analysis is subject to limitations beyond those already described. First, any limitations in GBD 2016 cause-of-death estimation are also applicable to this study.27 For GBD 2016, we aimed to better account for cause-of-death data quality by developing a metric for well-certified deaths and using this measure to inform GBD data standardisation and correction processes. Nonetheless, establishing and maintaining high-quality vital registration systems is essential to improved cause-of-death estimation. For instance, abrupt or prolonged conflict can lead to cause-of-death data gaps or lags in reporting; subsequently, HAQ Index performance might not yet fully capture the ramifications of conflict on health…
HAQ Index: Rankings
Healthcare Access and Quality Index: Performance on the HAQ Index and 32 individual causes, by country or territory, in 2016. Click on thumbnails to view pages as individual image files (jpg format) or click on the link below to view a PDF of the data. 1 2 3 4 5 6 Healthcare Access and Quality Index 2016 from The Lancet (pdf)Download Source: GBD 2016 Healthcare Access and Quality Collaborators. “Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016.” Lancet (London, England) vol.…
Healthcare Access and Quality Index: Results
"The HAQ Index performance followed distinct geographical patterns in 2016 (figure 1), with most countries in the highest decile clustered in Europe or nearby (ie, Iceland), and almost all countries in the lowest decile located in sub-Saharan Africa. Exceptions to this pattern included Canada, Japan, Australia, and New Zealand in the tenth decile, and Afghanistan in the first decile. More heterogeneity emerged among the next deciles of performance (eg, USA, UK, Malta, Lebanon, Singapore, and South Korea, in the ninth decile; Cuba, Chile, Saudi Arabia, and Russia, in the eighth decile). Most Latin American countries scored between the fourth and…
Healthcare Access and Quality Index: Overview
"Measuring health-care access and quality has become an increasingly important priority alongside its ascent in global health policy. In particular, the use of amenable mortality—deaths from causes that should not occur in the presence of effective medical care—to approximate national levels of personal health-care access and quality has gained greater traction.6–15 Amenable mortality metrics are thought to provide a strong signal of what can or should be addressed by the receipt of effective health care, and thus performance on overall personal health-care access and quality. Combining such measures with those capturing avertable or preventable health outcomes (ie, burden that can…
