US Lags Behind 10 Other Countries in Care

In a survey of physicians in 11 countries, the United States seems to be lagging behind when it comes to a number of areas in healthcare.

The Commonwealth Fund International Health Policy Survey, published online in Health Affairs, found American doctors were far less likely to use health information technology (HIT) to reduce errors and improve care. Less than half (46%) of US physicians use electronic medical records compared to 99% in the Netherlands and 97% in New Zealand and Norway.

More than 10,000 primary care physicians were surveyed in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States. According to the report, the US could learn the most from other countries in the survey by expanding access to care and use of HIT, using financial incentives to improve quality and efficiency, and simplifying insurance.

"We spend far more than any of the other countries in the survey, yet a majority of US primary care doctors say their patients often can’t afford care, and a wide majority of primary care physicians don’t have advanced computer systems to access patient test results, anticipate and avoid medication errors, or support care for chronically ill patients," Cathy Schoen Commonwealth Fund senior vice president and lead author of the report, said in a statement.

While 58% of US physicians reported their patients often have trouble paying for medications or other out-of-pocket costs, the rest of the countries reported this was only true for between 5% and 37% of patients.

Long waits to see specialists is a common issue among the 11 countries, however. While 28% of US doctors report patients facing a long wait to see a specialist, 35% of Australians and 22% of UK physicians reported the same. These were the lowest rates in the survey. According to the Commonwealth Fund, 75% of Canadian and Italian physicians reported long waits to see specialists.

American physicians also ranked most poorly when it came to after-hours care outside of the emergency room. And they’re doing worse today. In this latest survey, just 29% of physicians reported having an arrangement for patients to see a doctor or nurse after hours, which was a significant drop from 40% in 2006.

"Access barriers, lack of information, and inadequate financial support for preventive and chronic care undermine primary care doctors' efforts to provide timely, high quality care and put the US far behind what many other countries are able to achieve," Karen Davis, president of the Commonwealth Fund, said in a statement. "Our weak primary care system puts patients at risk, and results in poorer health outcomes, and higher costs. The survey provides yet another reminder of the urgent need for reforms that make accessible, high-quality primary care a national priority."