Canada has the worst record for surviving heart attacks and the best rate of survival from childhood leukemia, according to an international comparison of health outcomes.

Researchers used a list of health indicators to evenly compare five wealthy countries: Australia, Canada, Britain, New Zealand and the United States.

The list includes survival rates for key types of cancer, kidney and liver transplants, heart attack and stroke as well as suicides and preventable diseases like measles.

In 2001, Canada spent $2,792 per capita compared to $4,887 in the U.S.

"None of the five countries ... is consistently the best or the worst on all 21 indicators," study co-author Gerard Anderson of Johns Hopkins University's school of pubic health told a telephone briefing.

Acute myocardial infarction or heart attack and stroke data were available from Canada, Australia and New Zealand.

"The higher case-fatality rate [for heart attacks] among older people in Canada is an area that warrants investigation," the study's authors wrote in Tuesday's issue of the policy journal Health Affairs.

The average severity of attacks, ambulance response rates and hospital characteristics such as length of stay can affect the 30-day fatality rate for heart attacks, the report said.

In Canada, five-year cancer survival rates were generally average or above average, according to the report.

The U.S. results were slightly better than Canada's for breast cancer, cervical cancer, non-Hodgkins lymphoma, pertussis and measles.

Per capita spending on health in Canada is 57 per cent of that in the U.S. but Canadian survival rates for colorectal cancer, childhood leukemia, kidney transplants, liver transplants and hepatitis B were higher.

"Spending more does not necessarily result in better outcomes, at least on these 21 indicators," Anderson said. He co-authored a study in the same issue of the journal that compared per capita health care spending in 2001.

The study was sponsored by the Commonwealth Fund, a private foundation that supports independent research on health and social issues.