USA Child (0-4) and Adult (55-74) Mortality and % GDP-Health Expenditure and the Other Western Countries 1989-2015. America needs an “National Neighbourhood Health Service”

Abstract

Purpose: To analyse how effective was the USA, compared to Other Western Countries (OWC) in reducing premature deaths 1989-2015.Design: This population-based study is a cost-effective model of fi scal input into health related to clinical outputs, recognising socio-economic factors infl uence health outcomes. Using World Bank data for total % GDP-Expenditure-on-Health, and, WHO data for Child (0-4), Adult (55-74) and Age-Standardised-Death-Rates rates per million America is compared with OWC. Cost-Effective Ratios (CEF) are calculated and Confi dence Intervals (95%) tests USA against each OWC. `Excess' deaths are calculated between the most and least expensive health systems. Setting: Twenty Other Western countries.Patients: National populations.Outcomes: USA highest current total %GDPEH 16.8% and highest average of 12.7% and UK lowest 7.1% over period.USA Child (0-4) highest at 1249pm, OWC averaged 803pm. Fourteen countries had signifi cantly bigger reductions than America.USA Adult (55-74) mortality was highest at 12,554pm, OWC averaged 9,835pm. Fourteen countries had signifi cantly bigger reductions than USA.Excess Deaths: America failed to match UK total mortality rates yielding 488,273 excess deaths, of which 12,613 were children.