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World Health Systems Facts

Healthcare Access and Quality Index


HAQ Index 2019

HAQ Index 2016


“Amenable mortality, or deaths from causes that should not occur in the presence of high-quality health care,15,16 has been used as a measure of the health-care dimension of health system performance for nearly 50 years.15–42 The most widely used list of causes of mortality amenable to health care was developed by Nolte and McKee, and has since been used to compare high-income countries’ performances at length.10,18,20–37 A recent study by Kruk and colleagues34 used case-fatality rates for causes included in the McKee and Nolte list and additional diseases to estimate the separate effects of utilisation versus quality for 137 countries. The only studies that are global in scope, however, are the Healthcare Access and Quality (HAQ) Index studies, developed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD).23,24 The HAQ Index is also the only approach that makes estimates of health-care access and quality comparable across locations using risk-standardised death rates (RSDRs) and mortality-to-incidence ratios (MIRs), as a way of excluding drivers not connected to the health system.”

Source: GBD 2019 Healthcare Access and Quality Collaborators (2022). Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. The Lancet. Global health, 10(12), e1715–e1743. https://doi.org/10.1016/S2214-109X(22)00429-6


Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.


Page last updated March 24, 2023 by Doug McVay, Editor.

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