|
Volume 12 Number 88 Lead Report: Quality Despite spending more money on health care, the United States ranks last in several key quality and access measures compared to five industrialized nations, according to a study scheduled for release May 15. The study by The Commonwealth Fund found the United States ranked behind Australia, Canada, Germany, New Zealand, and the United Kingdom in many health care measures, in part due to the lack of both universal health insurance coverage and a national health information technology infrastructure. The United States ranks last on health care measures of quality, access, efficiency, equity, and outcomes, said the report, Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care. The United States performs poorly on these measures despite spending nearly double on health care per capita than the other countries studied, the study found. The United States spent $6,102 per capita on health care in 2004, compared to $3,165 for Canada, $3,005 for Germany, $2,876 for Australia, $2,546 for the United Kingdom, and $2,083 for New Zealand, said the report, the third the Commonwealth Fund has produced on the issue. Poor Performance "Our failure to ensure health insurance for all and encourage stable, long-term ties between physicians and patients shows in our poor performance on measures of quality, access, efficiency, equity, and health outcomes," Commonwealth Fund President and study lead author Karen Davis said in a press release. "In light of the significant resources we devote to health care in this country, we should expect the best, highest performing health system," Davis said. "The U.S. needs to make a major commitment to improving health insurance coverage and quality of care," the report said. "If it fails to act, not only will the U.S. standing among the world's health systems continue to erode, but there will be a predictable rise in public dissatisfaction and significant economic and human costs," it added. The study found the United States ranked fifth of the six countries studied on quality measures, such as safe care and coordinated care. For example, the United States ranked last in patients reporting that they have a regular doctor (84 percent versus as high as 97 percent in other countries). The United States ranked last overall on health care access measures, including when care was available. For example, 61 percent of U.S. patients reported it was somewhat or very difficult to get care on nights or weekends, compared with between 25 percent and 59 percent for the other countries. Last In Efficiency The United States also ranked last in efficiency measures, such as percent of patients who have visited the emergency room for conditions that could have been treated by a regular doctor if one had been available. The United States ranked fifth of the six countries on primary care practices with electronic records capabilities, such as electronic prescribing and patient reminder systems (19 percent compared with compared with as high as 87 percent in other countries), according to the study. The United States performs best in preventive care, said the study, but nevertheless scores poorly on the ability to promote healthy lives. The most notable way the United States differs from the other countries studied is its absence of universal health care, the Commonwealth Fund said. "Other nations ensure the accessibility of care through universal health insurance systems and through better ties between patients and the physician practices that serve as their long-term 'medical home,'" the study stated. "It is not surprising, therefore, that the U.S. substantially underperforms other countries on measures of access to care and equity in health care between populations with above-average and below-average incomes." More information is available on The Commonwealth Fund website.
|
