US Health Care: Not so Good

December 3rd, 2008 | Sources: Boston Globe, Health Affairs

In a survey of chronically ill adults in 8 affluent countries, US patients were the most likely to forego care due to high costs and rate their care as inefficient and error prone.

This according to Cathy Schoen and her team, who surveyed 7,500 adults chosen at random in France, Germany, Netherlands, Canada, Australia, New Zealand and the US. The study was published in Health Affairs.

Participants had at least one chronic illness such as arthritis, diabetes or heart disease. They had rated their health as fair or poor, or reported that they had recently sustained a major illness, undergone major surgery or required hospitalization.

Overall, US patients viewed their health system more negatively than any other country. One-third said it ought to be rebuilt from the ground up and only one-fifth said it worked well. Dutch patients viewed their system most positively, followed by the British, French and Canadians.

54% of Americans reported at least one cost-related access problem in the previous year, such as skipping medication doses, not filling prescriptions and not seeing a physician during an illness. This was highest among the 8 countries.

Only 7% of Dutch participants reported that costs were a barrier to accessing medical services.

41% of Americans indicated they incurred at least $1,000 in out-of-pocket medical expenses in the last year. That happened to just 5% of French and 4% of British respondents.

One third of US respondents reported experiencing a medical error, receiving an incorrect medication or dosage, delays receiving test results or receiving incorrect test results. That was higher than any other country.

Meanwhile, half the US respondents indicated their time had been wasted at least once in the past 2 years because medical records or test results weren’t available when needed.

Patients in the Netherlands were most likely to report positive access and care coordination experiences, although management of hospital discharges and information hand-offs between multiple specialists were found to be error-prone in all countries.


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