A survey of preventable deaths in 19 industrialized countries has found that France ranks first in providing appropriate healthcare while the United States is last on the list. The study, entitled "Measuring the Health of Nations: Updating an Earlier Analysis," was published in the January/February issue of the journal Health Affairs.

What the bottom is that if the health care system in the United States performed as well as those of those top three countries, there would be 101,000 fewer deaths per year. The study analyzed data from 2002 and 2003. While France had 64.8 deaths deemed preventable by timely and effective health care per 100,000 people, the United States had 109.7 such deaths per 100,000 people, the researchers alleged.

"It is notable that all countries have improved substantially except the US," said Ellen Nolte, lead author of the study.

There are previous rankings covering 1997 and 1998, and France topped that earlier list too. All countries made some progress, but the United States fell 4 places nevertheless from the 15th to the 19th place in 2002-2003.

"It is startling to see the U.S. falling even farther behind on this crucial indicator of health system performance," said Cathy Schoen, the Senior Vice President of the Commonwealth Fund, a private New York-based health policy foundation which funded the study.

"The fact that other countries are reducing these preventable deaths more rapidly, yet spending far less, indicates that policy, goals and efforts to improve health systems make a difference," Schoen added in a statement.

First was France, followed by Japan and Australia, Spain was fourth best, followed in order by Italy, Canada, Norway, the Netherlands, Sweden, Greece, Austria, Germany, Finland, New Zealand, Denmark, Britain, Ireland and Portugal, with the United States last.