Health and wellness

Bad health care the biggest cause of preventable deaths in most countries, study finds

Nearly 60 per cent of deaths from treatable conditions in low- and middle-income countries are caused by substandard care, not lack of access to treatment

PUBLISHED : Thursday, 06 September, 2018, 3:41pm
UPDATED : Thursday, 06 September, 2018, 4:24pm

Nearly six in 10 deaths from treatable conditions in low- and middle-income countries result from low-quality health care – a bigger killer than insufficient access to treatment, according to a report released yesterday.

Every year, about five million people in these countries die as a result of substandard care, says the report published in medical journal The Lancet.

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This was out of 8.6 million total deaths from treatable conditions, and far outweighs the 3.6 million deaths from lack of access to health care.

Overall, deaths from treatable conditions cost the global economy some US$6 trillion in 2015 alone, the researchers found, pointing to “systematic deficits” in primary and hospital care.

“For too long, the global health discourse has been focused on improving access to care without sufficient emphasis on high-quality care,” said Muhammad Pate, a co-author of the report by The Lancet Global Health Commission, of which he is co-chairman.

“Providing health services without guaranteeing a minimum level of quality is ineffective, wasteful and unethical,” Pate added, warning there was a “vast epidemic of low-quality care”.

Quality care should not be the purview of the elite, or an aspiration for some distant future
Margaret Kruk, Harvard T.H. Chan School of Public Health

Substandard care was a factor in 84 per cent of cardiovascular deaths, 81 per cent of vaccine-preventable diseases, and 61 per cent of post-birth complications examined by the report.

Typically, mothers and children in low- and middle-income countries received less than half the number of recommended interventions – including blood pressure monitoring during birth, and newborn check-ups.

Less than half of suspected tuberculosis cases were correctly managed, and fewer than one in 10 people with a major depressive disorder received even minimally adequate treatment, the report said.

“Diagnoses are frequently incorrect for serious conditions” such as pneumonia, heart attacks, or newborn asphyxia, a condition that can cause death by suffocation, it added. “Care can be too slow for conditions that require timely action, reducing chances of survival.”

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Among women receiving medical care during pregnancy, the wealthiest were four times more likely to have urine and blood tests done, and to have their blood pressure monitored.

The highest toll was in India, where substandard health care was responsible for an estimated 1.6 million deaths a year, the researchers said.

“Quality care should not be the purview of the elite, or an aspiration for some distant future; it should be the DNA of all health systems,” said commission co-chair Margaret Kruk of the Harvard T.H. Chan School of Public Health.

“Countries will know they are on the way towards high-quality, accountable health systems when health workers and policymakers choose to receive health care in their own public institutions.”