I have been looking at health care ratings in order to better inderstand the criteria used to support the findings. I have found the WHO report could be used to rate government health care, but private health care providers are at a distinct disadvantage. The fairness used in the criteria synthesizes cost and distribution and does not reflect absolute health care quality, instead how evenly the care is distributed and the cost is shared by the population.

More on that later if anybody is interested....


As far as infant mortality rates, I found that different countries use different definitions of stillbirth. For example, Austria, Germany, Denmark, Belgium and France use weight, the length of the infant or length of the pregnancy. Those 5 countries are also at the bottom of the CIA list, with the lowest # of infant mortality per 1000 births...

https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html

Since the US uses the highest standard, if the infant shows any sign of life upon emerging from the mother it is considered a live birth, its no wonder the US is not higher on the list.

But when we look closer, even at that disadvantage, the US only has 3 less infant deaths in 1000 births than France, who ranked the best among my examples.

To me that speaks volumes and sheds light on how extrodinary the US pedatric care really is.

Here is the statute of limitations for stillbirth...

http://www.eurocat.ulster.ac.uk/pdf/Report-8-Appendix-7.pdf



Styria (Austria) Population-based I Province of Styria Late fetal death from a Crown Foot Length>=35cm. From 01.01.95 limit of >=500g introduced by law Up to 1 year

Mainz (Germany) Population-based III Mainz District (Rhineland Palatinate) Weight ***8805; 500g Recorded up to 1 week
Saxony-Anhalt (Germany) Population-based III Federal State Saxony-Anhalt Weight >=500 g introduced by law 1.4.94 (before 1.4.94 >=1000 g) Recorded up to 1 week. Available up to 1 year

Odense (Denmark) Population-based I County of Fünen Gestational age at 28 weeks or more. Up to 7 years for cases seen at paediatric department.

Antwerp (Belgium) Population-based I Province of Antwerp >180 days Recorded up to 1year.
Hainaut (Belgium) Population-based II Provinces of Hainaut (South) & Namur 28 weeks or 180 days Recorded up to 1.

Paris (France) Population-based III Greater Paris 22 weeks after LMP Recorded up to 1 week (hospital discharge)
Strasbourg (France) Population-based III Department of Bas-Rhin Before 1993: 180 days. After 1993: 22 gestational weeks 2 to 5 years

An infant born and did not meet the criteria for live birth, but actually lived 11 months before passing does not count on their infant mortality rate because it is labeled a stillbirth.

What do you think?

The fairness used in the criteria synthesizes cost and distribution and does not reflect absolute health care quality, instead how evenly the care is distributed and the cost is shared by the population. How is that not a factor in "absolute" health care quality?


Since the US uses the highest standard, if the infant shows any sign of life upon emerging from the mother it is considered a live birth, its no wonder the US is not higher on the list. The US standard is not the "highest", simply different on paper (and not as uniform among states as your info suggests) - in practice, how do you think the others are estimating those ages?

And the stats are easily corrected - simply include the stillbirth rates. Unfortunately, including the stillbirth rates (which would pick up all those dead babies not classed as "child mortality") does not improve the US ranking much, if at all - many countries that spend half as much on health care as the US have better stillbirth numbers, as well as child mortality stats.

http://creativedestruction.wordpress.com/2006/05/22/regarding-the-uss-high-infant-mortality-rate/

However, most of these countries are doing as well or better than the US in all categories, including stillbirths. That’s incompatible with the claim that the US’s infant mortality problem is a statistical illusion caused by different standards for categorizing stillbirths.
- - - - -
Even when stillbirth deaths are included, the US is still doing significantly worse than countries credited with low infant morality rates. It is therefore impossible that the US’s poor standing is caused entirely by the exclusion of stillborn children from infant mortality statistics (although this exclusion may be a contributing factor).

http://www.statcan.gc.ca/pub/84f0210x/2006000/5201672-eng.htm


The number of stillbirths (or fetal deaths) in Canada was 2,272 in 2006, an increase of 63 stillbirths (2.9%) from 2005.

The stillbirth rate remained stable at 6.4 per 1,000 total births (live births and stillbirths) between 2005 and 2006.
D.1. Trends in stillbirth rates

Since 1991, stillbirth rates have fluctuated around 6.0 per 1,000 total births (Chart 5). The lowest rate was 5.6 in 1991 and the highest was 6.4 in 2003, 2005 and 2006. However, the late stillbirth rate (fetal deaths at 28 or more weeks of gestation) peaked at 3.8 per 1,000 in 1992, and has since decreased to 3.0 in 2006.
- - - - -
D.2. Stillbirth rates, by geography

Stillbirth rates varied considerably across Canada in 2006, from 4.0 per 1,000 total births in Quebec to 12.9 per 1,000 in the Northwest Territories (Table 4). Four provinces and one territory registered stillbirth rates below the national average: Quebec, Prince Edward Island, New Brunswick, Saskatchewan and the Yukon Territory. In all the other provinces and territories, stillbirth rates were above the national average.

http://en.wikipedia.org/wiki/Stillbirth

Stillbirth is a relatively common, but often random, occurrence. The mean stillbirth rate in the United States is approximately 1 in 115 births, which is roughly 26,000 stillbirths each year, or on an average one every 20 minutes. In Australia,[5] England, Wales, and Northern Ireland, the rate is approximately 1 in every 200 births, in Scotland 1 in 167. - - .[6]

How is that not a factor in "absolute" health care quality?

Are you implying you can't understand the basic fact that 2 different definitions for what constitute a stillbirth will create recorded data that, if compared, will give a skewed view of the facts?

If every chart, of every infant born in those countries was reviewed and the same standard applied to stillbirth as the US then, yes.

Otherwise your comparing apples to oranges.

You can take all the apples, the countries in my example, and accuratley rate them in terms of infant mortality, because they use a similar definition of stillbirth..

Its an even playing field, nobody has an advantage. I have no reason to continue with you if you cannot objectivley grasp this simple fundemental.

Are you implying you can't understand the basic fact that 2 different definitions for what constitute a stillbirth will create recorded data that, if compared, will give a skewed view of the facts? I thought that "basic fact" was the entire topic of my post.

I see by rereading that my memory was correct, and my entire post addressed exactly that concern.

So what are you talking about?

I thought that "basic fact" was the entire topic of my post.

I see by rereading that my memory was correct, and my entire post addressed exactly that concern.

So what are you talking about?

You addressed with links that contained "facts" that are entirely wrong and misleading.



Even when stillbirth deaths are included, the US is still doing significantly worse than countries credited with low infant morality rates. It is therefore impossible that the US’s poor standing is caused entirely by the exclusion of stillborn children from infant mortality statistics (although this exclusion may be a contributing factor).

France had 3 less infant deaths out of a 1000 births. .3% :rolleyes:

Also, they do not specifically say they equalled the definition of stillbirths, they just said "even with stillbirths included".

You can assume they did all you want.

You addressed with links that contained "facts" that are entirely wrong and misleading. Which ones would those be?

France had 3 less infant deaths out of a 1000 births. .3% That's a huge difference.

Also, they do not specifically say they equalled the definition of stillbirths, they just said "even with stillbirths included". Very slowly:

your post, the OP, said that the lousy infant mortality rates in the US were a statistical illusion caused by the US counting deaths as "infant mortality" that other countries count as "stillbirths". According to your post, the US was counting more deaths as "infant mortality" and fewer as "stillbirth", compared to some other countries listed.

So I posted sources that show the US also has lousy stillbirth stats. So it doesn't matter whether the dead babies are counted as "stillbirth" or "infant mortality", the US has more of both added together than other first world countries (and many second world countries).

That is just one of the evaluation criteria of a national health care system. As with essentially every other outcome based criterion used to evaluate medical care delivery, the US system sucks.

Which ones would those be?

I clearly requoted the first source you offered.


That's a huge difference.

This post shows your lack of critical thinking



Very slowly:

your post, the OP, said that the lousy infant mortality rates in the US were a statistical illusion caused by the US counting deaths as "infant mortality" that other countries count as "stillbirths". According to your post, the US was counting more deaths as "infant mortality" and fewer as "stillbirth", compared to some other countries listed.

So I posted sources that show the US also has lousy stillbirth stats. So it doesn't matter whether the dead babies are counted as "stillbirth" or "infant mortality", the US has more of both added together than other first world countries (and many second world countries).

That is just one of the evaluation criteria of a national health care system. As with essentially every other outcome based criterion used to evaluate medical care delivery, the US system sucks.

Your blinders are so firmly attached you are now putting words in my mouth, have fun in your left wing bubble. :wave:

Which ones would those be?
”
I clearly requoted the first source you offered. You asserted wrong or misleading "facts" from some "links", without further identification.

Which facts, from which links?

btw: Here are the words I put in your mouth:


As far as infant mortality rates, I found that different countries use different definitions of stillbirth. - - - -
- - - -
Since the US uses the highest standard, if the infant shows any sign of life upon emerging from the mother it is considered a live birth, its no wonder the US is not higher on the list.

Do you wish to disown them?

You asserted wrong or misleading "facts" from some "links", without further identification.


Not sure if your reffering to my OP or my first response to you so I will cover both. If I mislead you then please point out how. My premise is that it has no bearing on my overall point that the US pediatric industry really does a pretty dam good job. You may have found a clerical error, but the differences we're taking here is 1 or two 2 out of a thousand. And second, 1 or 2 tenths of a percent varience could be chalked up to anything, especially when there is not a uniform definition of stillbirth used. The difference from the best #224 Singapore and #180 United States is less than 4 in 1000 births or 4 tenths of a percent, incredibly small.



Which facts, from which links?

The first one you linked in this thread, and to be honest, the part you quoted was so grossly lacking objectivity, I didn't read any further. My OP merely made an observation about the way stillbirths are determined and recorded and asked what do you think? Your reply, and first link you quoted, made the point I was trying to make for me. The media is spreading news that is inaccurate and some people take it hook, line and sinker.



btw: Here are the words I put in your mouth:

Here is what you said.


your post, the OP, said that the lousy infant mortality rates in the US...

I never said that the rates were lousy, the whole point of this thread is to show how well the US health care industry really is. But thats not what the liberal media tells us.


Do you wish to disown them?

See above.

Which facts, from which links?
”
The first one you linked in this thread, and to be honest, the part you quoted was so grossly lacking objectivity, I didn't read any further. So no facts, from any links, were involved in your complaints about "misleading facts" from my "links". I suspected as much.

My premise is that it has no bearing on my overall point that the US pediatric industry really does a pretty dam good job. Your main point was that the infant mortality stats used to criticize the US system were misleading. I blew that out of the water.

You may have found a clerical error, but the differences we're taking here is 1 or two 2 out of a thousand. And second, 1 or 2 tenths of a percent varience could be chalked up to anything, especially when there is not a uniform definition of stillbirth used. The difference from the best #224 Singapore and #180 United States is less than 4 in 1000 births or 4 tenths of a percent, incredibly small. The US infant mortality rate is 6.26/1000, the French 3.3/1000, according to your link. The difference is almost 90% - almost double. Similarly with every other first world medical system - the US rates poorly, by that criterion, and often by very high percentages. France is not the best - there's Singapore, at 2.75/1000, and several others.

And the difference in stillbirth definitions only helps a little: the US has high stillbirth rates as well, so it doesn't matter which category these countries put their dead babies in, the US still rates poorly. That is probably because the US medical care delivery system sucks. And it is the most expensive of all.

The media is spreading news that is inaccurate and some people take it hook, line and sinker. You, for example, seem to have bought into a media deception that aligns with the media's continual assertion that the US system is a standard First World performer.