['Public health status and perspectives' 1997. VI. Effects of health care]

The aim of this study was to investigate whether more health improvement might be attained with existing medical interventions. The interventions for ten diseases were studied to assess their efficacy (effect in ideal, experimental situation), their effectiveness (effect in daily practice) and the discrepancy between the efficacy and effectiveness. In addition, the causes of unexpectedly low effectiveness were studied. Interventions with proven efficacy were identified for all ten diseases. The effectiveness was less often studied. Existing health care registrations could provide information on the effectiveness for only three diseases (tuberculosis, colorectal tumours, and acute myocardial infarction). Causes of unexpectedly low effectiveness were observed in several of the five phases of the process of care: contacting the health care system, diagnosing the disease, prescribing the appropriate intervention, executing the intervention and patient compliance.