Intended for healthcare professionals


Health system report ranks UK first, US last

BMJ 2014; 348 doi: (Published 17 June 2014) Cite this as: BMJ 2014;348:g4080
  1. Michael McCarthy
  1. 1Seattle

The United Kingdom was ranked highest overall, Switzerland second, and the United States last in a new report that compared the health systems of 11 developed nations.1 The US, the report noted, spent more than $8500 (£5000; €6270) per capita on health in a year, while the UK spent less than half that, at $3400 per person.

The study was the fifth in a series produced by the Commonwealth Fund. It draws on international surveys that the New York City based foundation has conducted with patients and doctors, as well as data on health spending and outcomes from the Organisation for Economic Cooperation and Development and the World Health Organization.

The report ranked the 11 countries in this order:

  • The UK,

  • Switzerland,

  • Sweden,

  • Australia,

  • Germany and the Netherlands (a tie),

  • New Zealand and Norway (another tie),

  • France,

  • Canada, and

  • The US, which was ranked lowest for the fifth time in a row.

The report ranked the nations according to five measures of health system performance: quality of care, access to care, efficiency, equity, and healthy lives, which were based on indicators such as infant mortality or mortality amenable to healthcare. The US came last or nearly last in four of …

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