tirsdag den 15. september 2009

WHO's internationale sammenligninger af sundhedssystemer

David Friedman diskuterer en WHO sammenligning af verdens 192 lande for sundheds-systemer. WHO har lavet en system, der rangordner landene ud fra en række kriterier. Det er ren sammenblanding af pærer og bananer og Friedman konkluderer, at det er værdiløst. Og fortsætter:

"In fairness, I should add that I don't have any proposal for doing a much better job of comparing international health care systems, given the data limitations when trying to look at 192 different countries. Ideally, one would want a value added measure, something like the difference between actual life expectancy in a country and what life expectancy would be if there were no health care system at all. But I don't see any practical way of generating such numbers. One could simply use life expectancy, but that has the problems I have already described. One can try to look at particular outcomes heavily dependent on health care; the U.S. apparently does very well measured by cancer survival rates. But neither approach really tells you what you want to know."
Hovedproblemet med WHO's rangordning er, at den benytter størrelser, som ikke siger ret meget om, hvad sundhedsvæsenet rent faktisk leverer. Et af målene er middellevetid, som er bestemt af mange andre ting end ydelserne i sundhedsvæsenet (rygning, fedme, bilulykker, mord etc.).

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