Though the U.S. spends a higher portion of its GDP on health care than any other country, it ranked last in a survey conducted by the Commonwealth Fund in 2014. This survey assessed the healthcare systems of the United Kingdom, United States of America, Switzerland, Sweden, Australia, Germany, Netherlands, New Zealand, Norway, France, and Canada.

Commonwealth Fund Survey 2014

The indicators of quality are grouped into four categories: ➠ Effective care ➠ Safe care ➠ Coordinated care ➠ Patient-centered care In terms of quality care, the top three spots were bagged by the United Kingdom, Australia, and Switzerland. New Zealand ranked fourth, whereas the United States and Netherlands both held the fifth position. Germany, France, Canada, Sweden, and Norway held the seventh, eighth, ninth, tenth, and eleventh rank, respectively. Effective care is an indicator of quality, which is determined by finding out if the services are effective and appropriate for the prevention and treatment of a given condition, as well as controlling chronic illness. For instance, sending reminders to patients who are due or overdue for tests or follow-up visits, and discussion of lifestyle-related issues can help in the prevention of diseases. An effective healthcare system can also be determined by the level of care provided to those with chronic illnesses. The following list provides the rankings (best to the worst) of these eleven countries in terms of effective care: ➠ United Kingdom ➠ New Zealand ➠ United States of America ➠ Australia ➠ Netherlands ➠ Germany ➠ Canada ➠ Switzerland ➠ France ➠ Sweden ➠ Norway Safe care implies avoiding medical errors or injuries to patients from the care that is intended to help them. Thus, precautions must be taken to prevent sicker patients from contracting an infection during a hospital stay or shortly after. The following list provides the rankings (best to the worst) of these eleven countries in terms of safe care: ➠ United Kingdom ➠ France ➠ Australia ➠ Switzerland ➠ Sweden ➠ Germany ➠ Netherlands and United States of America ➠ New Zealand ➠ Canada ➠ Norway Lack of coordinated care could have an adverse effect on the delivery of effective care, thereby raising the costs of treatment. There's a need for proper communication among patients, physicians, and hospitals. For instance, providing a written plan on aftercare measures after discharge can certainly prove beneficial. The following list provides the rankings (best to the worst) of these eleven countries in terms of coordinated care: ➠ United Kingdom ➠ New Zealand ➠ Switzerland ➠ Australia ➠ Netherlands ➠ United States of America ➠ Norway ➠ Canada ➠ France ➠ Germany ➠ Sweden Countries fared better in this category when there was proper communication between the patient and healthcare provider. The patient is more likely to continue seeking medical assistance from the same healthcare provider when care is provided while keeping the needs and preferences of the patient in mind. This is most likely to happen when the healthcare provider gives clear instructions, explains all the options to the patients, and encourages them to ask questions. The following list provides the rankings (best to the worst) of these eleven countries in terms of patient-centered care: ➠ United Kingdom ➠ Switzerland ➠ Netherlands ➠ United States of America ➠ Australia ➠ New Zealand ➠ Germany ➠ Canada ➠ Sweden ➠ France ➠ Norway

Health systems were also ranked on the basis of access to care. In a good healthcare system, patients are able to obtain affordable care and receive medical attention on time. On the other hand, countries where patients did not get the needed medical attention due to the inability to pay medical bills got a lower rank. The following list provides the overall rankings (best to the worst) of these eleven countries in terms of access ➠ United Kingdom ➠ Switzerland and Germany ➠ Netherlands and Sweden ➠ Norway ➠ New Zealand ➠ Australia ➠ Canada and the United States of America ➠ France Access is further divided into cost-related problem and timeliness of care. The following list provides the rankings (best to the worst) of these eleven countries in terms of cost-related problem: ➠ United Kingdom and Sweden ➠ Norway ➠ Germany ➠ Canada ➠ New Zealand ➠ Switzerland ➠ Netherlands ➠ Australia ➠ France ➠ United States of America In countries with a good healthcare system, patients have rapid access to basic medical care and non-emergency surgery. The following list provides the rankings (best to the worst) of these eleven countries in terms of timeliness of care ➠ Switzerland ➠ Netherlands ➠ United Kingdom ➠ Germany ➠ United States of America ➠ Australia ➠ New Zealand ➠ Norway ➠ Sweden ➠ France ➠ Canada

The quality of care should be maximized in terms of the resources. The resources should be well-spent. Avoidance of administrative hassles and insurance-related issues, timely access to records, etc., can help maximize efficiency. The following list provides the rankings (best to the worst) of these eleven countries in terms of efficiency ➠ United Kingdom ➠ Sweden ➠ New Zealand ➠ Norway and Australia ➠ Switzerland ➠ Netherlands ➠ France ➠ Germany ➠ Canada ➠ United States of America

Equity refers to delivery of good care to all, irrespective of location, socioeconomic status, gender, or ethnicity. Countries where patients with low income go without the needed care due to costs got a lower rank. The following list provides the rankings (best to the worst) of these eleven countries in terms of equity ➠ Sweden ➠ Switzerland and the United Kingdom ➠ Germany ➠ Australia ➠ Norway ➠ France ➠ Netherlands ➠ Canada ➠ New Zealand ➠ United States of America

In this category, countries were ranked on the basis of the mortality rates amenable to health care, infant mortality rate, and healthy life expectancy above the age of 60 years. The following list provides the rankings (best to the worst) of these eleven countries in terms of healthy lives: ➠ France ➠ Sweden ➠ Switzerland ➠ Australia ➠ Netherlands ➠ Norway ➠ Germany ➠ Canada ➠ New Zealand ➠ United Kingdom ➠ United States The rankings or the scorecard in the Commonwealth Fund is based on the information from the WHO 2000 report on health care, patients' and physicians' survey results on care experiences and ratings on various dimensions of care, data from the recent Commonwealth Fund international surveys, etc.

WHO's Rankings on Health Care (2000)