Do National Healthcare Funding Systems Make a Difference?

It’s always fun to see how Canada’s healthcare system ranks against the rest of the world. But it could also be useful, because such comparisons might just point to what we can change to make things better here at home. So when I recently came across some rankings on the World Population Review site, I couldn’t resist diving in.

Feel free to explore all the data I used for this post at this link.

The site featured multiple rankings, including five separate measures of overall quality of healthcare:

• Legatum Prosperity Index which measures objective outcomes like life expectancy, disease burden, and sanitation access.

• CEO World Magazine whose rankings are primarily based on surveys of healthcare professionals.

• US News & World Report which measures things like capacity and accessibility through surveys, data, and expert analysis.

• Numbeo which is based mostly on user satisfaction surveys.

• World Health Organization which measures healthcare affordability and outcome metrics.

The really nice thing about having easy access to all five of those rankings is that we’re getting a broad range of methodologies, increasing the chances that the numbers will actually mean something.

Overall Rankings

The first thing I did was normalize and combine the scores from all five rankings. Hopefully, this will give us a more robust comparison. Canada came in at number 34 (out of 196 countries). The U.S. - which spends far more on healthcare per capita than anyone else - ranked 41st and the U.K. was just one stop higher. Here are the top 15:

Overall Healthcare Rankings

After seeing those results, my first thought was “Colombia in third place? Really?” While I can’t be completely confident this isn’t just a weird statistical anomaly, it does seem that Colombia’s reputation for medical tourism and general affordability could be playing legitimate roles here.

Other Metrics

Besides the overall rankings, World Population Review also provided specific rankings, including ICU beds per capita, procedure wait times, and best doctors. Let’s look at those one at a time.

Here are the top-14 ranked nations for ICU beds per 100,000 residents (Canada is tied for 10th spot with Japan):

Despite scoring 46th overall, Turkey is particularly well stocked in the ICU beds department. That’s certainly an important measure of preparedness, but it’s obviously not the whole story.

Only 16 countries were rated by median wait times for surgery. Specifically the data covered cataract surgery, hip replacements, and knee replacements. Here are the average wait times (in days) for a combination of all three procedure categories:

Canada’s 97-day delays earn it ninth place overall, but for people living with pain while waiting for solutions, that’s small consolation.

Determining the country with the “best doctors” is only incrementally sillier than the average patient assuring us that Hospital X has the best doctors in town. How do you measure “best”? And where did you go to get data that’ll intelligently cover every doctor?

The World Population Review points us to BSCHOLARLY for help - although I really don’t know how useful it’ll be. You see, that ranking isn’t much more than an enumeration of famous medical discoveries and innovations. Canada’s relatively high ranking, for instance, seems to be based on Banting’s discovery of insulin (in 1923!) and Roberta Bondar being the first neurologist to travel to space.

Nevertheless, we’ll throw this one into the mix, too:

The best doctors data also covered doctor density (i.e., the number of doctors per 100,000 population). Here’s how that looked:

Canada ranked 74th with 25 doctors/100k.

Measuring Correlation

I then ran a regression analysis for three of those measures against our overall healthcare ranking (I left wait times out). Was I in for a surprise.