The study compared how successful each country is in converting health resources into “longer life, stronger prevention, and equitable access to care.”
The United Nations has a goal to ensure healthy lives for all ages (Goal 3 of the Sustainable Development Goals), which sets targets for maternal health, child survival, combating infectious diseases, and more.
## National Health
This research was headed by Ali Emrouznejad, Professor and Head of Business Analytics at the University of Surrey, whose research focuses on efficiency analysis and performance measurement in public services, where he said: “Money is not everything when it comes to national health.”
The study assessed performance by examining how effectively countries convert spending and employment into outcomes. This approach favors systems that reach people early, ensure equitable care, and avoid waste.
In this context, the team built a composite indicator, which is a single score that combines several health metrics into one measure. It balances indicators that reflect desired outcomes, such as coverage, and undesirable outcomes, such as mortality.
The researchers used the directional distance function (DDF), a method that measures how far a country is from the best practice frontier. Simply, it checks “who gets more health for the same or fewer inputs.”
The analysis linked indicator weights to a penalty to promote fairness and compared results across alternative models. In this work, Australia, Norway, Sweden, Iceland, and Israel scored the highest overall.
The model also takes into account climate-related pressures, which can put pressure on prevention and care. This choice is important because heat, smoke, and floods disrupt services and exacerbate chronic diseases.
Public confidence in health institutions affects how people use services and follow guidelines. When trust is strong, prevention programs reach more people and treatment begins earlier.
Systems with low public confidence often experience delays in care and confusion about access. These delays raise costs later and weaken national performance on key health measures.
## Where Wealth and Health Separate
The United States spent $12,555 per person on health, yet the average life expectancy was 76.4 years, several years lower than the OECD average. These figures are taken from the OECD’s country profile.
High spenders can still fall behind when access is unequal and prevention is weak, while countries that facilitate access to primary health care often avoid costly hospital care later.
Many high-performing countries ensure universal coverage, and everyone can get the care they need without financial hardship. This policy aligns incentives toward early detection and stable management of common conditions.
Effective systems also track data closely and adjust resources quickly. They reduce avoidable illnesses by keeping waiting times short and vaccination rates high.
## Global Patterns Behind Health Efficiency
Many countries with low population densities coordinate their services more tightly, reducing disparities in access and reducing delays. These systems often prioritize basic care first, as it supports the bulk of health needs.
Other countries rely more on private insurance, which can lead to gaps in coverage. These gaps weaken prevention and raise costs when problems worsen before anyone receives care.
Climate risks are not a distant problem for health planners. The recent Lancet Countdown report documents rising risks of heat, smoke exposure, and weather shocks that exacerbate existing health gaps.
Countries that build heat and flood-resistant clinics, protect workers, and plan for sudden temperature increases tend to keep services running.
## What Does This Mean for Leaders of the World’s Richest Countries?
* Prevention provides more health care per dollar than rescue care. The costs of vaccination, controlling high blood pressure, and supporting mental health are low compared to intensive care in hospitals.
* Equity is a performance strategy, not just a statement of value. When coverage is comprehensive, people seek care early and complications decrease.
* Strong primary health care absorbs shocks, including seasonal waves and climate-related events. When the front door holds, hospitals are not overcrowded.
In this regard, Professor Ali Emrouznejad says: “Policy makers should prioritize prevention, sustainability, and equitable access to health services, rather than just increasing health budgets.”
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