In order to achieve universal health coverage, it is necessary to ensure that all populations have access to quality health care. It is critical that both progress and setbacks in reaching universal health coverage are closely examined to guide further decisions and strategies for future improvement. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) in addition to the Healthcare Access and Quality Index (HAI) for 195 countries and territories as well as subnational locations in seven countries, researchers assessed personal health-care access and quality.
"Researchers used 32 causes from which death should not occur in the presence of effective care to approximate personal healthcare access and quality by location over time. To better isolate potential effects of personal healthcare access and quality from underlying risk factor patterns, researchers risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. The mortality-to-incidence ratios for cancers were used instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0–100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0–100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita.”
Based on study findings, the GBD 2016 provides a clearer understanding of past successes and current challenges in improving personal healthcare access and quality worldwide. While the year 2000 saw substantial gains, many low-SDI and middle-SDI countries will continue to face significant challenges unless policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. In tandem with initiatives to strengthen public health programmes, the pursuit of universal health coverage depends upon improving both health access and quality of healthcare worldwide. It requires adopting a more comprehensive view—and subsequent provision—of quality health care for all populations.