World Health Report 2000 "Financial fairness indicator": useful compass or crystal ball?
The World Health Report 2000 generated a huge amount of controversy when it set out to rank the performance of national health systems using data, statistical measures, and an explanatory rationale that were neither well understood nor broadly accepted. This article demystifies the conceptual and empirical underpinnings of the report's "financial fairness index," which resulted in country rankings that often seem counterintuitive. The author concludes that the index is seriously flawed, that rankings produced by the index should not be used, and that future WHO reports should avoid imputing financial fairness scores for countries that do not have real data.
Shaw
R Paul
RP
Human Development Group, World Bank Institute, Washington, DC, USA. Rshaw@worldbank.org
D000043:Abstracting and Indexing / Q000592:standards; D019985:Benchmarking / Q000706:statistics & numerical data*; D003627:Data Interpretation, Statistical; D005191:Family Characteristics; D019538:Health Care Surveys; D005102:Health Expenditures / Q000145:classification* / Q000706:statistics & numerical data; D006801:Humans; D017059:Models, Econometric; D009313:National Health Programs / Q000145:classification* / Q000191:economics* / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care; D015203:Reproducibility of Results; D012935:Social Justice; D012959:Socioeconomic Factors; D014944:World Health Organization