International comparisons of healthcare quality
The interactive charts below explore a range of indicators across primary, acute and cancer care, where comparable international data is available. For more information, including data, methods and further analysis, see our in-depth report, Focus on: International comparisons of healthcare quality.
Definitions and comparability for all the indicators discussed above are taken directly from the OECD report Health at a Glance 2013: OECD indicators. Detailed information about the definitions and the source and methods for each country can be found on the OECD website.
Choice of countries
In these indicators we compare the UK to a pool of 14 countries considered to be relevant comparators for one or more of the following reasons:
- They are a similar western European country or have a similar level of economic development.
- They have a minimum population of approximately 10 million people.
- They have a similar type of health system to the UK.
- They are historically relevant.
The following 14 countries were selected for comparison: Australia, Belgium, Canada, France, Germany, Greece, Ireland, Italy, the Netherlands, New Zealand, Portugal, Spain, Sweden and the US. For indicators where the OECD best is not one of these 14 comparator countries or the UK, we highlight the best performer from the OECD overall for illustrative purposes.
It should be noted that not all of the countries report data on all of the indicators or do so regularly. Lack of data can actually be a signal for possible gaps in performance but we do not explicitly focus on under-reporting here. The OECD publishes UK-wide data and so in this report we look at the performance of the UK as a whole. These data are supplied at the UK level by the Department of Health. In most cases, a breakdown of the figures for England, Wales, Scotland and Northern Ireland is not available.
For more information, see the related QualityWatch report: Focus on: International comparions of healthcare quality.
For the schedule of vaccinations please see the NHS Choices website.
For all vaccinations some caution should be exercised when comparing coverage figures over time due to data quality issues reported by some data providers. Apparent trends could reflect changes in the quality of data reported as well as real changes in vaccination coverage. Please see individual data collections for any additional information associated with this data.
'Influenza vaccination rate' refers to the number of people aged 65 and over who have received an annual influenza vaccination, divided by the total number of people over 65 years of age. The main limitation in terms of data comparability arises from the use of different data sources, whether survey or programme, which are susceptible to different types of errors and biases. For example, data from population surveys may reflect some variation due to recall errors and irregularity of administration. A number of countries changed the way in which influenza vaccination rates were calculated between 2005 and 2011. These countries are: Chile, Denmark, Germany, Israel, Luxembourg, New Zealand, Slovenia, Switzerland and the United Kingdom.
Childhood vaccination programmes
Vaccination rates reflect the percentage of children that receive the respective vaccination in the recommended timeframe. The age of complete immunisation differs across countries due to different immunisation schedules. For those countries recommending the first dose of a vaccine after age one, the indicator is calculated as the proportion of children less than two years of age who have received that vaccine. Thus, these indicators are based on the actual policy in a given country. Some countries administer combination vaccines (e.g. DTP for diphtheria, tetanus and pertussis) while others administer the vaccinations separately. Some countries ascertain vaccinations based on surveys and others based on encounter data, which may influence the results.
Mortality following a stroke
The admission-based case-fatality rate is defined as the number of people aged 45 and over who died within 30 days of being admitted to hospital for ischemic stroke, where the death occurs in the same hospital as the initial stroke admission. The in- and out-of-hospital case-fatality rate is defined as the number of people who die within 30 days of being admitted to hospital with a stroke, where the death may occur in the same hospital, a different hospital or out of hospital. Rates were age-sex standardised to the 2010 OECD population aged 45+ admitted to hospital for stroke. The change in the population structure in this edition of Health at a Glance compared with previous editions (where rates were standardised using the 2005 OECD population of all ages) has led to a general increase in the standardised rates for all countries.
Mortality following acute myocardial infarction (AMI)
The admission-based case-fatality rate following AMI is defined as the number of people aged 45 and over who die within 30 days of being admitted to hospital with an AMI, where the death occurs in the same hospital as the initial AMI admission. The in- and out-of-hospital case-fatality rate is defined as the number of people who die within 30 days of being admitted to hospital with an AMI, where the death may occur in the same hospital, a different hospital, or out of hospital. Rates were age-sex standardised to the 2010 OECD population aged 45+ admitted to hospital for AMI. The change in the population structure in this edition of Health at a Glance compared with previous editions (where rates were standardised using the 2005 OECD population of all ages) has led to a general increase in the standardised rates for all countries.
Breast and cervical cancer screening coverage
Number of women aged 20-69 who have been screened for cervical cancer within the past three years (or according to the specific screening frequency recommended in each country) divided by the number of women aged 20-69 answering the survey question (for survey-based data) or eligible for an organised screening programme (for programme-based data). In many countries, the recommended screening frequency will be every three years. Countries were selected based on data availability. Note: ^ - Survey data * - Programme data.
Relative survival is the ratio of the observed survival experienced by cancer patients over a specified period of time after diagnosis to the expected survival in a comparable group from the general population in terms of age, sex and time period. Relative survival captures the excess mortality that can be attributed to the diagnosis. For example, relative survival of 80% mean that 80% of the patients that were expected to be alive after five years, given their age at diagnosis and sex, are in fact still alive (OECD Health at a Glance, 2013).
Cancer survival calculated through period analysis is up-to-date estimate of cancer patient survival using more recent incidence and follow-up periods than cohort analysis which uses survival information of a complete five-year follow-up period. In the United Kingdom, cohort analysis was used for 2001-06 data while 2006-11 data are calculated through period analysis. The reference periods vary slightly across countries. All the survival estimates presented here have been age-standardised using the International Cancer Survival Standard (ICSS) population (Corazziari et al., 2004). The survival is not adjusted for tumour stage at diagnosis, hampering assessment of the relative impact of early detection and better treatment (OECD Health at a Glance, 2013).
Mortality rates are based on numbers of deaths registered in a country in a year divided by the size of the corresponding population. The rates have been directly age-standardised to the 2010 OECD population to remove variations arising from differences in age structures across countries and over time. The source is the WHO Mortality Database. Deaths from all cancers are classified to ICD-10 codes C00-C97. Mathers and others (2005) have provided a general assessment of the coverage, completeness and reliability of data on causes of death. Mortality rates of colorectal cancer are based on ICD-10 codes C18-C21 (colon, rectosigmoid junction, rectum, and anus).