Dear HIFA colleagues,
In a previous message Nkwan Jacob (Cameroon) stated: “According to the World Health Organization, 60% of deaths occur in the hospital due to poor quality of care rather than at home due to lack of care”
https://www.hifa.org/dgroups-rss/antimicrobial-resistance-amr-4
Zakiuddin Ahmed (Pakistan) asked Nkwan if he could please share the reference.
https://www.hifa.org/dgroups-rss/antimicrobial-resistance-6
Nkwan has shared the reference with Zakiuddin and myself today. Here it is:
WHO: 'Sixty per cent of deaths in LMICs from conditions requiring health care occur due to poor quality care, whereas the remaining deaths result from non-utilization of the health system.'
https://www.who.int/news-room/fact-sheets/detail/quality-health-services
It would be interesting to explore WHO's statement further.
Clearly, poor quality care and failure to access the health system are major causes of death.
WHO uses the denominator 'deaths from conditions requiring health care'. What it means by this is unclear. Some would argue that *all* deaths are 'from conditions requiring health care'. (Almost) all conditions require care, whether this is for prevention, diagnosis, management, symptom relief or palliation.
Taken literally, the WHO statement implies that poor quality care and lack of access to care are responsible for all deaths, but this is clearly not the case. Some patients clearly receive quality care and nevertheless die, in which case we should be talking at minimum of three cohorts: X% die due to poor quality care, Y% die due to failure to access care, and Z% die despite receiving 'good' care.
I suspect that WHO has ommitted a key word, and that the statement should say 'Sixty per cent of AVOIDABLE deaths in LMICs from conditions requiring health care occur due to poor quality care, whereas the remaining deaths result from non-utilization of the health system.'
Can anyone unpack this further?
Many thanks, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org