Poor quality of health care was a major driver of excess mortality across conditions

That headline may not be a surprise to many, but it is a central finding of a study entitled “Mortality due to low-quality health systems in the universal health coverage era: a systematic analysis of amenable deaths in 137 countries” by Kruk et al. recently published in The Lancet. Other findings from said article include the estimation of “8.6 million excess death [] amenable to health care,” 5 million of which were due to “poor quality care” and 3.6 million due to “non-utilization of healthcare.” This is out of “19.3 million total deaths in 2016 in LMICs from the 61 specific causes and age groups considered in this study”. Furthermore, the authors estimate that “7.0 million deaths [were] preventable through public health intervention”. That is, in these 61 countries, approximately 15.6 million deaths, 80% of all deaths that year, were due to insufficiencies in healthcare and not because we don’t know how to provide such care.

This is progress of a sort. People dying of cardiovascular disease is something of a sign of a growing middle class, while the respiratory issues (including tuberculosis and chronic respiratory) indicate the direction of motion. That is, more and more people are dying because of “old people” diseases (cancer, sad as it is to say, a sign of a prospering nation), than of “third world” diseases (which also have outweighed significance in Figure 2 with their towering violet bars of “poor quality”).

But, it’s also 15 million people whose lives were cut short because what we know doesn’t always go to where we need it. And 600,000 others who you may have been comfortable with discarding in the approximation to make a point, but upon even the slightest moment’s reflection you realized that to forget that even these 600,000 deaths were entirely preventable based on medical care standards to which we in the “23 high-income reference countries with strong health systems” are accustomed. And but so 15.6 million people could have lived a little longer if we but spread what we know.

And put a little work into it.