Poor-quality care is now a bigger barrier to reducing mortality than insufficient access.
In 2015 alone, these deaths resulted in US$6 trillion in economic losses. More than 8 million people per year in LMICs die from conditions that should be treatable by the health system. Quality of care is worst for vulnerable groups, including the poor, the less educated, adolescents, those with stigmatised conditions, and those at the edges of health systems, such as people in prisons. One in three people across LMICs cited negative experiences with their health system in the areas of attention, respect, communication, and length of visit (visits of 5 min are common) on the extreme end of these experiences were disrespectful treatment and abuse. At the system level, we found major gaps in safety, prevention, integration, and continuity, reflected by poor patient retention and insufficient coordination across platforms of care. Care can be too slow for conditions that require timely action, reducing chances of survival. Diagnoses are frequently incorrect for serious conditions, such as pneumonia, myocardial infarction, and newborn asphyxia. In LMICs, mothers and children receive less than half of recommended clinical actions in a typical preventive or curative visit, less than half of suspected cases of tuberculosis are correctly managed, and fewer than one in ten people diagnosed with major depressive disorder receive minimally adequate treatment. The Lancet Regional Health – Western Pacificĭata from a range of countries and conditions show systematic deficits in quality of care.The Lancet Regional Health – Southeast Asia.The Lancet Gastroenterology & Hepatology.
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