International Comparison of Health Care Data: Methodology development and application

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Mortality rates can be influenced by a myriad of factors, one of which is the quality of the health care system for diseases where mortality is amenable to health care. The mortality rate number of deaths per , people, adjusted for age differences across countries has been falling in the U. Mortality amenable to healthcare is a measure of the rates of death considered preventable by timely and effective care. While the health care system might not be expected to prevent death in all instances, differences in amendable mortality indicate how effectively health care is delivered. The Healthcare Access and Quality HAQ Index is based on amenable mortality and uses age-standardized, risk-standardized mortality rates for 32 causes that timely and effective health care could potentially prevent.

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Based on data from the Global Burden of Disease Study, the HAQ Index is scaled from 0 to lower scores indicate high mortality rates for causes amenable to health care, while higher scores indicate lower mortality rates and thus better quality of and access to health care. The U.


It is measured by adding together the total number of years that people who died before an specified age e. For example, a person who dies at age 45 would have a YLL of As a measure, it provides more weights to deaths at younger ages. Disability adjusted life years DALYs are a measure of disease burden and the rate per , shows the total number of years lost to disability and premature death. Hospital admissions for certain chronic diseases like circulatory conditions, asthma, and diabetes, can arise when prevention services are either not being adhered to or delivered.

Hospital admission rates in the U.


However, the U. Mortality within 30 days of being admitted to a hospital is not entirely preventable, but can be reduced for certain diagnoses and services. Improvement in this area is often linked to improved quality of care. The day mortality rates for ischemic strokes caused by blood clots is 4.

The day mortality rates after hospital discharge for heart attacks acute myocardial infarction and hemorrhagic stroke caused by bleeding are similar in the U. According to a recent survey by the Commonwealth Fund, patients in the United States are more likely than those in comparable countries to experience a medical error at some point during their care. In this case, medical errors include being given the wrong medication or dose, or experiencing delays or errors in laboratory test results.

Another way to measure the quality of the health care system is to ensure patients are receiving recommended care without additional harm. Post-operative pulmonary embolisms or deep vein thrombosis are most common after major surgeries, such as hip or knee replacement. Sepsis is a life-threatening condition that occurs when an infection within the body is either resistant to treatment or goes untreated. During and after surgery, the likelihood of a patient becoming septic can be greatly reduced by following proper safety and cleanliness precautions as outlined by the World Health Organization.

Multiple factors can cause wound dehiscence, including faulty stitches or infection. Wound dehiscence and suture ruptures following major surgery are associated with longer hospital stays or readmission, more expensive healthcare costs, and increased morbidity.

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Obstetric trauma is more likely to occur in deliveries where instruments are utilized i. Among comparable countries, the U. However, the rate of obstetric trauma during deliveries with an instrument in the U. While there is debate over the best way to measure outcomes for cancer, the U. In , the mortality rate for breast and cervical cancers in the U. For colorectal cancers, the U. The mortality rate for all cancers has fallen steadily in the U. The length of detention has been associated with the severity of mental disorders and psychosocial issues.

Some migrant workers, especially those with low level skills, are employed in sectors often amongst the most dangerous, difficult and demeaning 3Ds , with low wages, hazardous and harsh working conditions, and a lack of status recognition, social protection and occupational health rights.

Global Health

WHO provides a list of sources of health data , although not specific to migration and health. Potential data sources on migration and health may be derived from various sources such as:. Civil registration, vital statistics and population censuses : Administrative data sources and censuses provide information on the births and deaths and cause of deaths of people. Household surveys: Demographic and Health Surveys DHSs are nationally representative household surveys that provide data on a wide range of health and nutrition-related information.

Such surveys are usually tailored to the needs of a particular country while containing several basic components that are comparable across all countries. Although DHSs provide data on rural-urban migration, only a few stipulate whether people move internationally.

A review of 85 national DHSs found detailed information via a dedicated migration module to only be present in 12 surveys. For children, their migration status can sometimes be identified through their mothers' migration status. In cases where a separate section on international migration appears in the questionnaire, children who left the household to go abroad can also be identified, along with their basic characteristics. The Living Standards Measurement Study LSMS is another household survey programme focused on generating high-quality data for evidence-based policy making.

UK Health Accounts - Office for National Statistics

The migration module of LSMS surveys typically includes questions on place of birth, most recent place of residence, reasons for moving, number of times moved and types of migration including inter-district, rural-urban and international migration. Health Institution-based records : National Hospital Registries provide data on health-related information pertinent to hospitalization, and National Epidemiological Disease surveillance systems provide information on diseases, conditions and outbreaks that may affect public health.

However, most providers and insurers do not routinely collect data by legal status or on the national origin of the cases registered. Such approaches in Cancer registries have been utilized as an effectively compare disease burden among migrant groups. One example is the Mekong Basin Disease Surveillance programme.

Associated Data

Foreign employment bureaus and migrant worker welfare agencies : These sources may capture data on health insurance claims of migrant workers indicating morbidities , mortality in case of migrant worker deaths and data on deportations based on medical grounds. BioMosaic shows foreign-born populations, census demographic data, and health-data indicators to the US county level.

Targeted health communications, or public-health interventions, can be developed with the application by identifying foreign-born populations clustered in specific areas, or link census data on social determinants of health, such as income, education, language proficiency and access to healthcare. Research studies and reviews on the health of migrants at national level : Undertaking empirical research and systematic reviews provides vital health-related information on migrants that if meaningfully applied can catalyze policy formulation and inform practice interventions.

For example, the Government of Sri Lanka in partnership with IOM published a compendium of migration health research that presented key data on health of migrant and mobile population groups by disease e.

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  • Malaria and by migrant typology inbound, outbound, internal migrants and families left-behind. Migration health assessments capture a range of health information by migrant type. For example, in IOM provided annual reporting of , health assessments of immigrants and refugees that it undertakes on behalf of governments and migrants. IOM also generates empirical analyses of findings for select population groups such as refugees. The information can be used to better understand the prevalence of diseases such as tuberculosis and conditions such as malnutrition among populations examined, and enable health authorities in both sending and receiving countries to better address the health of migrants.

    The Portal contains data in the form of technical reports and publications that are disaggregated by country, health issues and type of migrant group. Whilst the portal focuses on data from IOM related projects and interventions, it will expand as a global repository of all peer-reviewed publications on migration and health using rigorous bibliometric methods. Country Migration Profiles : A Migration Profile is a country-owned tool, prepared in consultation with a broad range of stakeholders which can be used to enhance policy coherence, evidence-based policymaking, and the mainstreaming of migration into development plans.

    However, only few have included a health component within their profile. Better guidance and investment is needed to provide governments with the tools to map migration health country profiles, as per methods and sources outlined in this brief. No singular metric can be used as an aggregate measure of the health of migrants. A global health indicator framework for measuring and monitoring the health of migrants does not exist and specific guidance on what data to collect and how to collect has not been developed.

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    The need to enhance health information systems and enable rigorous methodologies and capacities for collection of data on migration health, across all migrant groups at the national level remain a challenge for both developing and developed nations. A review led by IOM in of European research on migration and health identified areas for which better information on gathering migration and health data are needed, and the first Global Consultation in Migration Health held in outlined key policy questions and priorities to address in collecting migrant health data.

    The framework provides a basis for which data may be systematically collected but no evidence exists of whether the indicator framework has been applied at the national level. As noted previously, several limitations in harnessing migration health data exist. First, data on the health of migrants and mobile population groups are not routinely collected by health information systems at sub-national, national, regional and global levels.

    Even with the DHS, countries can opt out of asking questions on mobility.