country has the most state of the art health care

[nec209]

What country has the most state of the art health care like advanced technology,stem cell ,cloning ,bioengineering ,robotic,advanced surgery so on.

 

I hear the the biggest problem is cost ,getting specialists ,training for new medical stuff , getting new state of the art technology so on.And the US and Canada is not doing well when comes to this only some private very expensive cancer treatment centers ,surgery so on .in the US .Where one must get on plane to fly to that city.

 

I hear that India and Singapore are very good.When it comes to research and doing studies I think most 98% is still done in the US,

 

What is wrong with China or India ?

[lemur]

Presumably, revenues are still expected to remain higher in the US; otherwise expensive doctors would move away. Personally, I don't know if it's worth maintaining such high insurance costs to sustain the high revenue-expectations of US doctors and pharmaceuticals. Maybe the US should harmonize its health-care prices with a global standard.

[JohnB]

You could always try lifting the standards to match the rest of the developed world.

[lemur]

You could always try lifting the standards to match the rest of the developed world.

 

That's a broad and vague implication that there is a dominant global standard for the developed world. Can you give some specific examples?

[John Cuthber]

OK, not 33rd on this list would be a start

http://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate

A better place in this one might be better too

http://en.wikipedia.org/wiki/List_of_countries_by_death_rate

 

 

Also if you could do it without spending a lot more than anybody else (as a % of GDP) that would be good too.

 

http://en.wikipedia.org/wiki/Health_care#Health_care_by_country

 

 

I think the developed world roughly corresponds to this

http://en.wikipedia.org/wiki/OECD

[Pangloss]

The almost trivial differences in numbers between the top countries on those lists is meaningless if you can't tell me why some countries are higher and other countries lower. Implying that it's due to socialized medicine is meaningless -- you must show causation.

 

IMO the problem is cost, not care.

[Marat]

The real problem with medicine in the Anglo-Saxon world is that it is so over-regulated by both government restrictions and professional medical society regulations that patients and their doctors are prevented from resorting to scientific experiments to address the patient's disease after all 'approved' treatments have failed. This is in striking contast to the situation in Germany, where patients and their doctors have much more freedom to try anything they both agree is scientifically worth attempting, so that health care is potentially much better for those for whom the most conventional, conservative approaches are not effective. It does the patient little good to have more MRIs per capita in the U.S. than anywhere else if his physician's license can be pulled by the state medical board if he dares to prescribe vitamin C.

[John Cuthber]

I'd love to be able to supply a reason, but I can't; my guess is that it's rather complicated but the infant mortality in the US is twice as high as the leaders'.

 

Twice as much chance of a child dying isn't something I would describe as "almost trivial".

[Pangloss]

I'd love to be able to supply a reason, but I can't; my guess is that it's rather complicated but the infant mortality in the US is twice as high as the leaders'.

 

Twice as much chance of a child dying isn't something I would describe as "almost trivial".

 

It is when it's actually only a three tenths of a percentage point higher chance to die. Notice that the same data cannot be interpreted to mean that Japanese hospitals are "twice as good as American hospitals" in handling infant care. I wouldn't be surprised if a child would have a higher chance to live in an above-average American hospital versus a below-average Japanese hospital. That doesn't mean we can't draw from this and improve, but it should stop us short of drawing sweeping generalizations in the political realm.

 

(Statistical significance measurements might be helpful here.)

[CharonY]

There are comparisons like that out there. One that I had saved was between Canada and the US:

 

Ananth et al. Int J Epidemiol. 2009 Apr;38(2):480-9.

 

RESULTS: The overall stillbirth rate in the United States (37.9 per 10,000 births) was similar to that in Canada (38.2 per 10,000 births), while the overall infant mortality rate was 23% (95% CI 19-26%) higher (50.8 vs 41.4 per 10,000 births, respectively). The gestational age distribution was left-shifted in the United States relative to Canada; consequently, preterm birth rates were 8.0 and 6.0%, respectively. Stillbirth and early neonatal mortality rates in the United States were lower at term gestation only. However, gestational age-specific late neonatal, post-neonatal and infant mortality rates were higher in the United States at virtually every gestation. The overall stillbirth rates (per 10,000 foetuses at risk) among Blacks and Whites in the United States, and in Canada were 59.6, 35.0 and 38.3, respectively, whereas the corresponding infant mortality rates were 85.6, 49.7 and 42.2, respectively.

 

CONCLUSIONS: Differences in gestational age distributions and in gestational age-specific stillbirth and infant mortality in the United States and Canada underscore substantial differences in healthcare services, population health status and health policy between the two neighbouring countries.

 

[Marat]

The Canadian statistics say nothing about its national public healthcare system or about its healthcare generally, since they are greatly distorted by the enormous infant mortality rate in Native reservations in the far North of the country, where poverty, alcoholism, drug use, and lack of access to first-class hospitals combine to produce a uniquely tragic situation. In contrast to the U.S., Natives in Canada make up three percent of the total population, so the distortion of the typical picture is considerable.

[Pangloss]

There are comparisons like that out there. One that I had saved was between Canada and the US:

 

Ananth et al. Int J Epidemiol. 2009 Apr;38(2):480-9.

 

Missing link. Here's another view:

 

Studies have come to different conclusions about the result of this disparity in spending. A 2007 review of all studies comparing health outcomes in Canada and the US in a Canadian peer-reviewed medical journal found that "health outcomes may be superior in patients cared for in Canada versus the United States, but differences are not consistent."[7] Life expectancy is longer in Canada, and its infant mortality rate is lower than that of the U.S., but there is debate about the underlying causes of these differences. One commonly-cited comparison, the 2000 World Health Organization's ratings of "overall health service performance", which used a "composite measure of achievement in the level of health, the distribution of health, the level of responsiveness and fairness of financial contribution", ranked Canada 30th and the U.S. 37th among 191 member nations. This study rated the US "responsiveness", or quality of service for individuals receiving treatment, as 1st, compared with 7th for Canada. However, the average life expectancy for Canadians was 80.34 years compared with 78.6 years for residents of the U.S.[8]

 

That's a well-sourced summary from the Wikipedia's article comparing the two systems, which may be found (along with all of its citations) here.

 

--------

 

Getting back to the question, I want to know if that chart listing all those health factors with such a tight tolerance has any data indicating statistical significance. Telling me that there's a difference between two data sets of 3 doesn't mean anything. What's the standard deviation? Is there ANOVA data? What is the confidence interval? Is there a t-test?

 

In short, how do I know that a difference of 3 (or 300, or 3 million) is significant? I'm not statistics expert by any stretch of the imagination (as my mangling of terms probably suggests), but even I know that this is important. Without it all I can guess is that there are a bunch of countries in the same general ballpark.

 

I would imagine that such indicators exist -- it's not a correlative study without significance. But we always seem to get this data without these indicators included. Blame the press, I suppose. I'll keep an open mind about it, but I'm not drawing any conclusions about why there's a difference until I really know that there is one.

 

Isn't that fair?

 

-------------

 

The Canadian statistics say nothing about its national public healthcare system or about its healthcare generally, since they are greatly distorted by the enormous infant mortality rate in Native reservations in the far North of the country, where poverty, alcoholism, drug use, and lack of access to first-class hospitals combine to produce a uniquely tragic situation. In contrast to the U.S., Natives in Canada make up three percent of the total population, so the distortion of the typical picture is considerable.

 

Source, please.

Edited December 14, 2010 by Pangloss
fixed an errant formatting tag

[CharonY]

Well, an epi-study without statistical evaluation would not be worth much, would it? But fair enough, I did not quote the statistical analysis.

They calculated rate rations and the 95% confidence intervals and for each cause of infant death, which includes congenital anomalies, injury etc. the rate was higher in the USA (within the mentioned CI) with the exception of maternal complications at term.

 

There was another study focusing on socio-economic factors, but I would have to dig for that.

[nec209]

Yes I hear European hospitals are more advanced when comes to stem cell.I hear people going to Europe for stem cell treatment.Also bacterial resistance is major problem and doctors in Europe are taking a radical move to use virus to kill the resistance bacterial .

 

When it comes to robotics and electronic stuff well Asia is the best. Many hospitals in Canada and US are old very old the new hospitals build no more than 5 years ago or hospitals run by universities do more scfi stuff like new drugs ,cloning ,stem cell and new treatments.Well the other hospitals get it 10 years later.

 

There was program on TV of person in a vegetable state and they used electrical pulse and over time the body stated to work .There was study of turning fat cells into heart cells and was inserted into person heart.And if that is not interesting enough there was show on discovery of person who had brain aneurysm there was no treatment do to the size and location of the aneurysm it would bleed to death the person. One a radical move they cooled the body down very cold the person was dead and did the operation than resuscitated. There has been other stuties of people in freezing water and was in for long time and person resuscitated.The cold prevents brain cells from dying or other cells and slow the body down.

 

Other very interesting thing on discovery they gave mice a gas and it made them go to sleep and than remove the gas and they woke up .No idea what the gas is but in the show they say in future a person that has gun shots or stabbing they can give person this gas to slow the body down .I think this the research going into hibernation.Well hibernation like in scfi on going on long space mission or putting person in hibernation and than 400 years in future wake them up is still very much scfi now .But they doing research on smaller scale a person in hibernation for short time. One of the big problems is icce crystals if the person is frozen for a long time.

 

But there is more study going into people and animals frozen and than resuscitated but has of now the longer the person or animals is frozen the harder it is to resuscitate the person.

 

I'm just saying only a handful mostly private hospitals that are very costly in the US or hospitals run by universities are using cutting edge.Some of best cancer treatment in Canada are in Toronto trying new treatment.Some new hospitals built in Toronto they put in all state of the art at the time of building and the best in Canada at the time of building.

[John Cuthber]

It is when it's actually only a three tenths of a percentage point higher chance to die. Notice that the same data cannot be interpreted to mean that Japanese hospitals are "twice as good as American hospitals" in handling infant care. I wouldn't be surprised if a child would have a higher chance to live in an above-average American hospital versus a below-average Japanese hospital. That doesn't mean we can't draw from this and improve, but it should stop us short of drawing sweeping generalizations in the political realm.

 

(Statistical significance measurements might be helpful here.)

 

 

Are you really saying that the fact that roughly twice as big a fraction American babies die young as do in Iceland is trivial?

That's odd. Infant mortality is widely used as a measure of the general health of a nation.

 

Given the large numbers of people involved (even with Iceland's small population) I think it's fair to assume that the difference between about 3 per mil and about 6 per mil is significant.

I can probably estimate the error margins if you want.

[Pangloss]

Well, an epi-study without statistical evaluation would not be worth much, would it? But fair enough, I did not quote the statistical analysis.

They calculated rate rations and the 95% confidence intervals and for each cause of infant death, which includes congenital anomalies, injury etc. the rate was higher in the USA (within the mentioned CI) with the exception of maternal complications at term.

 

There was another study focusing on socio-economic factors, but I would have to dig for that.

 

Thanks. Okay, so the data is valid -- it's statistically significant. We know that the difference between the United States and countries higher on the list is measurable, and that the difference is outside of the margin of error.

 

As you say the study doesn't tell us why there's a difference, but that's understandable. But there is something that the study should be able to tell us that could be quite informative: Does the difference in infant mortality rate between an above-average American hospital and a below-average American hospital tend to be greater than the difference between the overall average American hospital and the overall average hospital in a country near the top of that list?

 

If the answer to that question is "yes", then we may be able to generalize that if you're in one of those countries near the top of the list the infant mortality rate has more to do with which specific hospital you're in than what country you're in. You could even generalize a margin of safety -- a specific number for how far down you'd have to go on that list before you reached a country where you should think about leaving it for another country, as opposed to simply choosing a better hospital within that country.

 

Am I right or wrong here? What do you all think?

[CharonY]

I would think that this is somewhat irrelevant for broad comparisons as e.g. between countries. It is almost a no-brainer that there are variations within a country (and yes, there is a study for that, not committed to my memory, though). The goal of country-wide comparison are not to find out which hospitals are the best, but rather whether there are elements (infrastructure, funding, policies, accessibility etc.) on a country-wide basis that affect the health of the respective population.

The spread is more interesting to look within a country which local elements pertain to the spread. However, there was at least another study that compared infant mortalitiy in different cities around the world. What they focused on were socio-econmic disparities and found an inverse association with infant mortality and income in an US city (and also maybe in one European one), but I remember that at least in Paris and Tokyo there were none (forgot the other cities, could be London and New York). The strongest was found in the US city though. This is one example of a comparison on the microscale.

[nec209]

Why is it all replies in this thread has nothing to so with my post?

 

The thread subject was country has the most state of the art health care?

[Mr Skeptic]

Oh, do you mean like a single hospital with awesome tech, rather than the average healthcare of the country?

[CharonY]

Also in what area? The best hospitals are usually highly specialized in a specific field. E.g. cancer treatment, cardiovascular diseases, infectious diseases, etc. There is unlikely to be a single country filling all the top spots, though.

[nec209]

I think Asia is the best for robotics and electronic stuff and European hospitals are more advanced when comes to stem cell.

 

The US hospitals are old and very out dated other than some hospitals run by universities or handful of mostly private hospitals that are very costly .

[Pangloss]

I would think that this is somewhat irrelevant for broad comparisons as e.g. between countries. It is almost a no-brainer that there are variations within a country (and yes, there is a study for that, not committed to my memory, though). The goal of country-wide comparison are not to find out which hospitals are the best, but rather whether there are elements (infrastructure, funding, policies, accessibility etc.) on a country-wide basis that affect the health of the respective population.

 

If that's true then we can indeed use that data to state that one country's health care system is better than another's, but it seems to me that we cannot state, based on that data, that the difference is serious enough to warrant a significant change in approach.

 

In other words, the differences are statistically signifant, but not socio-politically significant. They don't suggest a need for dramatic change.

 

Of course that's just my opinion. What constitutes great change is a matter of opinion, and what constitutes great cost is a matter of opinion as well. In order to make a factual determination you'd need a cost-benefit analysis -- something that weighs all the expenses of the desired change against the potential progress that could be gained.

 

 

 

Why is it all replies in this thread has nothing to so with my post?

 

The thread subject was country has the most state of the art health care?

 

We haven't been able to agree on a way to determine that yet.

[nec209]

We haven't been able to agree on a way to determine that yet.

 

 

Well are you talking about state of the art technology or socialized medicine.Why because socialized medicine may make it fair for everyone but not state of the art technology .

 

Alot of the times the university hospitals or private hospital get state of the art technology before the other hospital .And patients in those hospitals are more likely to be on clicical trials like new drugs ,stem cell and other treatment than the other hospitals that get it 10 or 15 years later.

Edited December 30, 2010 by nec209

[jryan]

I'd love to be able to supply a reason, but I can't; my guess is that it's rather complicated but the infant mortality in the US is twice as high as the leaders'.

 

Twice as much chance of a child dying isn't something I would describe as "almost trivial".

 

 

When you consider that the US is also far ahead in teen pregnancy (and per capita teen pregnancy) it becomes clearer why we have a higher infant mortality rate. Especially when you consider that the US rate is 6.8 per 1000 while the Canadians are at 4.8.... while they have less than half the teen pregnancies.

 

Granted, there is more at play in the numbers, but to claim that the difference is due to health care is not really being accurate.

Edited January 8, 2011 by jryan

[Pangloss]

I'm not sure I followed that. Why should the rate be higher just because the volume is higher?