Evidence map›Paper›PMID 30195398›Full record

SynthesisLancet (London, England)2018

Mortality due to low-quality health systems in the universal health coverage era: a systematic analysis of amenable deaths in 137 countries.

Margaret E Kruk, Anna D Gage, Naima T Joseph, Goodarz Danaei, Sebastián García-Saisó, Joshua A Salomon

Erratum issuedAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Lancet (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 524 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
524citing papers in PubMed, 11 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

524 citing papers in PubMed, 11 syntheses or guidelines pooled it.

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  9. Effect of pharmacist care on clinical outcomes and therapy optimization in perioperative settings: A systematic review.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2024
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464 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Margaret E KrukDepartment of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA. Electronic address: mkruk@hsph.harvard.edu.
Anna D GageDepartment of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA.
Naima T JosephDepartment of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
Goodarz DanaeiDepartment of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA.
Sebastián García-SaisóMinistry of Health, Mexico City, Mexico.
Joshua A SalomonCenter for Health Policy and Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUniversal health coverage has been proposed as a strategy to improve health in low-income and middle-income countries (LMICs). However, this is contingent on the provision of good-quality health care. We estimate the excess mortality for conditions targeted in the Sustainable Development Goals (SDG) that are amenable to health care and the portion of this excess mortality due to poor-quality care in 137 LMICs, in which excess mortality refers to deaths that could have been averted in settings with strong health systems.

methodsUsing data from the 2016 Global Burden of Disease study, we calculated mortality amenable to personal health care for 61 SDG conditions by comparing case fatality between each LMIC with corresponding numbers from 23 high-income reference countries with strong health systems. We used data on health-care utilisation from population surveys to separately estimate the portion of amenable mortality attributable to non-utilisation of health care versus that attributable to receipt of poor-quality care.

findings15·6 million excess deaths from 61 conditions occurred in LMICs in 2016. After excluding deaths that could be prevented through public health measures, 8·6 million excess deaths were amenable to health care of which 5·0 million were estimated to be due to receipt of poor-quality care and 3·6 million were due to non-utilisation of health care. Poor quality of health care was a major driver of excess mortality across conditions, from cardiovascular disease and injuries to neonatal and communicable disorders.

interpretationUniversal health coverage for SDG conditions could avert 8·6 million deaths per year but only if expansion of service coverage is accompanied by investments into high-quality health systems.

fundingBill & Melinda Gates Foundation.

Indexed as

MortalityAdolescentAdultAgedAge DistributionChildChild, PreschoolDelivery of Health CareFemaleGlobal HealthHumansInfantInfant, NewbornMaleMiddle AgedQuality of Health Care

Identifiers

PMID30195398
PMCPMC6238021

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.