Jan. 8 (Bloomberg) -- More than 100,000 Americans die each year from lack of timely, effective medical care, according to a study that found the U.S. has the highest rate of preventable deaths among 19 industrialized nations.

In the five years through 2003, the rate of preventable deaths in the U.S. declined more slowly than in the other 18 market-based, democratic nations, according to the analysis published today by the policy journal Health Affairs. The U.S. is the only one of the 19 nations without universal health care coverage. About 47 million Americans lack insurance to help pay for rising medical costs.

If the preventable death rate in the U.S. improved to the average of the top three countries, France, Japan and Australia, 101,000 fewer Americans would die annually, the study said. The analysis was done by Ellen Nolte and C. Martin McKee of the London School of Hygiene and Tropical Medicine.

``There has been an increase in the past couple of years in the number of people in the U.S. who don't have access to insurance coverage,'' Nolte said in a telephone interview. ``People who don't have insurance tend to forgo, postpone or delay health care when they need it. It also leads to presentation at a later stage when less can be done.''

Focus of Study

The report focused only on people whose lives might have been extended by widely available medical or surgical interventions. The authors looked at more than 30 conditions that cause preventable deaths before age 75, including tuberculosis, thyroid disease, appendicitis, tetanus infections, abdominal hernia, colon cancer, measles and epilepsy. Deaths caused by leukemia, cervical cancer and diabetes were included only if victims were under 50 years old.

Although Nolte and McKee offered caveats about the reliability of the definitions that guided their analysis, the study is worthwhile as health care becomes an issue in the 2008 U.S. election, one expert said.

``Even if the death rate is overestimated in this study by 50 percent, our country is still high relative to the amount we spend on health care,'' said Catherine Hoffman, of the Kaiser Family Foundation, a nonprofit group in Menlo Park, California.

Still, it isn't always fair to compare the U.S. with other countries because of socioeconomic differences, she said.

``Some other countries are homogeneous in ethnic composition and income because they are more socialized in their tax structure and their middle class is bigger than our middle class,'' she said in a telephone interview. ``The U.S. is a diverse animal, and that plays out in many social dimensions.''

U.S. Drops to Bottom

In 1997-1998, the preventable death rate in the U.S. was 15th of the 19 nations, with 115 preventable deaths per 100,000 people. Five years later the rate improved to 110 preventable deaths per 100,000. The 4.4 percent improvement in the U.S. lagged behind the 18 other countries, and the overall preventable death rate in the U.S. was the highest of the 19 studied.

The biggest improvements in preventable death rates were found in Ireland, the U.K. and Austria. Ireland has improved access to some heart disease treatments, such as bypass surgery and anti-clotting drugs, Nolte said. All three countries have reduced smoking, improved diets and increased access to doctors and hospitals, she said.

Ireland's preventable death rate in 2003 fell 23 percent to 103 per 100,000 population; Austria's dropped 22 percent to 84 per 100,000; and the rate in the U.K. fell to 103 deaths per 100,000 people, a 21 percent decline.

The other countries in the study were Spain, Italy, Canada, Norway, the Netherlands, Sweden, Greece, Germany, Finland, New Zealand, Denmark and Portugal.

To contact the reporter on this story: Avram Goldstein in Washington at agoldstein1@bloomberg.net.

Last Updated: January 8, 2008 07:44 EST