South Korea has topped a 15-nation league table in terms of improvements made to its healthcare system over the last five years, while Spain's health service is the least-improved, according to new consumer research.

Generally, patients and the public in all 15 nations believe that overall access to their healthcare systems, their experiences and the systems' components are better now than they were five years ago, according the new International Healthcare Report Card released by Ipsos on behalf of Reuters News. However, the study also finds distinct differences in terms of the countries and the elements assessed.

The nations showing the greatest improvements in healthcare provision over the last five years are South Korea, Argentina, Japan and Belgium, while Spain, Hungary, Italy and France are floundering, it says.

The survey respondents assessed the access that they and members of their households have to healthcare services overall - including doctors, specialists, hospitals, diagnostic tests and medicines - plus, as a patient in their local community, how much easier is their ability to access those services today compared to 2008. 

Respondents were also asked about their recent patient experience compared to five years ago in visiting a doctor, receiving diagnosis, being referred to a specialist or for surgery, or treated for an accident or serious ailment or condition. They were asked about improvements in the following seven areas: the information which was shared with them, the options which they were given for treatment, quality, coordination, level of care, sensitivity to their needs and speed.

Ipsos used a scorecard based on net findings and a gap score analysis of the 15 nations to establish an overall score for each on the Report Card, and also gave them a letter grade, ranging from A+ to F. 

Respondents rated South Korea the highest for healthcare system improvement over the period, with a net score of 635 A+. It is followed by Argentina (net score 420 A); - Japan (291 A-); - Belgium (270 A-); Australia (216 B+); - US (199 B+); - Poland (160 B); - Germany (132 B); and - Canada (105 B-).

The UK is in tenth place, on 93 C+, followed by: Sweden (9 C-); - France (-2 D+); - Italy (-70 D); - Hungary (-136 D-); and - Spain (-372 F).

On overall access to healthcare, the leading nations are South Korea (+53), Argentina (+35), Belgium (+20) and Australia (+17), and Germany (+15), which has moved up from the middle of the table to fifth place.

South Korea leads again in total net scores for access to specific services (+250), followed by Argentina (+145), Japan (+98) and Belgium (+87), while Spain (-171) and Hungary (-76) score lowest.

On patient experience, South Korea again leads (+332), followed by Argentina (+241), Japan (+178), Belgium (+163), Poland (+133) and Australia (+132). The lowest scorers in this area are Spain (-164), Hungary (-37), Italy (-28), Sweden (+8) and France (+47).

It is evident, says Ipsos, that respondents in South Korea view their healthcare system as having improved substantially over the past five years, given that they outrank the other 14 countries on every measure. On access, the scores are: diagnostic tests +54, doctors +53, drugs +53, hospitals +49 and specialists +41. On patient experience, the scores are: - level of care +58, speed +51, quality +48, information +45, options +44, sensitivity +44 and coordination +42.

On the other hand, respondents in Spain have clearly seen a stark deterioration in their healthcare services - these take last place in every category. On access, Spain's scores are: drugs -47, specialists -43, tests -39, hospitals -34 and doctors -8. On patient experience, the scores are: level of care -27, options -27, coordination -25, quality -24, speed -24, sensitivity -23 and information -14.

Poland's overall score suggests a worsening of access to healthcare (-8), but only hospitals (-5) and specialists (-18) are rated to show degradations, and Polish patients' experience scores (+133) are positive, says the firm.

It also reports that most countries hold similar rankings across access and service improvements, apart from Japan, which ranks seventh in reported healthcare access (+15), and seventh in both service access (+98) and patient experience (+178), while Germany ranks fifth in overall healthcare access (+15) but falls to tenth place on patient experience (+73).