World Health Report 2000: the position of Slovak Republic

The World Health Organization (WHO) published the analysis of the health systems in 191 member states of WHO with important data (mostly for the year 1999) on probability of dying under age 5 years and between ages 15 and 59 years, life expectancy at birth, disability-adjusted life expectancy--DALE which is defined as the expectation of life lived in equivalent full health, responsiveness of health system, fairness of financial contribution and overall health system attainment. The last parameter was based on five weighted components: overall level of population health, health inequalities within the population, level of health system responsiveness, distribution of responsiveness between population and the distribution of health system financial burden within the population. Between 149 countries with more than 1 million inhabitants the rank for Slovakia (30th) is not bad and is close to Croatia and Poland. The estimates of overall health system performance (i.e. how efficiently health systems translate financial expenditure into health) belong to the problematic part of the report:. In this parameter the health system of USA ranks much lower than Turkey or Tunisia and Slovakia ranks lower than Albania. The authors did not take into consideration, that the health of population depends not only on health care and health expenditure but on many other factors, such as life style, nutrition, pollution, etc., which are not influenced by expenditure into health system. (Tab. 2, Fig. 6, Ref. 15.)