Health system goals: life, death and ... football.
OBJECTIVE
Both the World Health Organization (WHO) and the Fédération Internationale de Football Association (FIFA) have developed sophisticated ways of defining and aggregating performance to produce overall, single-number indices. These are used to illustrate some of the problems of measuring, comparing and improving health system performance.


METHODS
Possible associations between FIFA football rankings for international 'A' sides for 176 countries and rankings on the WHO overall health system performance index were explored using econometric techniques.


RESULTS
There is a significant relationship between a country's FIFA ranking and its ranking by the WHO. Taken at face value, the statistical analysis suggests that, if the national football team does well, the WHO score improves.


CONCLUSIONS
The relationship between FIFA and WHO ranks is entirely spurious. However, comparison of the two indices illustrates problems with the WHO exercise, including measurement difficulties, how policy-makers may use the information to improve health system performance, what the public are to make of the data and how different dimensions of overall performance may be subject to trade-offs.
Appleby
J
J
Health Systems Programme, King's Fund, 11-13 Cavendish Square, London W1G 0AN, UK.
Street
A
A
D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards; D009937:Organizational Objectives; D012916:Soccer; D012952:Societies; D006113:United Kingdom; D014944:World Health Organization