Heart Attack Care Better in Canada than the US

Summary: This study compared quality of care (eg, best clinical practices like prescribing the right medicines) for young adults (≤55) with an acute myocardial infarction. A low quality of care score was nearly 3 times more likely in the US than in Canada. So Canada, with inexpensive single payer, provides better care.

Variations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada, JAMA Netw Open, October 20, 2021, by V. Raparelli et al.

From Abstract:

Design, Setting, and Participants: This retrospective cohort analysis used data from 4048 young adults (aged ≤55 years) receiving in-hospital and outpatient care for AMI at 127 centers in the US and Canada. Analyses were adjusted for biological sex and social determinants of health.

Results: … [B]eing treated in the US was associated with a low Quality of Care Score both in-hospital (OR = 2.93) and post-AMI (OR = 2.67).

Comment:

By Jim Kahn, M.D., M.P.H.

Today’s reflection is concise: Canada’s single payer system delivers higher quality of care, while saving money, compared with the U.S. Better care processes help explain this astounding graph from OECD countries, which shows the US diverging on costs and longevity from other wealthy countries.

Costs less, works better. “Dominant”, in cost-effectiveness jargon. “Tastes great, less filling”, to quote the famous 1973 beer commercial. How many ways do we need to say it and show it?

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