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Home / News & IndustryManaged Care Insight and Analysis
Updated: January 26, 2010
Quality Gap Widening Between U.S.-World Doctors

In virtually every key criteria impacting primary care medicine, American doctors are lagging the efforts of their counterparts in 11 countries.

The lag is most critical in access, quality and use of health information technology and underscore an "urgent need" for national health reform, said New York City-based The Commonwealth Fund, the private foundation that aims to promote a high performing healthcare system for society’s most vulnerable. The frail primary care system puts patients at risk, and results in poorer health outcomes and higher costs, it added.

Commonwealth paid for the "2009 Commonwealth Fund International Health Policy Survey" that can be found online in the journal Health Affairs.

"The patient-centered chronic care model originated in the U.S., yet other countries are moving forward faster to support care teams, including nurses, spending time with patients and assuring access to (care) after-hours," said Commonwealth Fund Senior Vice President Cathy Schoen.

More than 10,000 primary care physicians in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom and the United States participated in the survey that describes a U.S. primary care system under stress and highlights areas where the U.S. can learn from other countries

Other key areas where U.S. physicians trail the world’s doctors are:

  • Financial incentives for improved quality;
  • After-hours care outside the emergency room;
  • Use of care teams and systems to care for patients with chronic illness;
  • Quality reporting and feedback; and
  • Tracking medical errors.

More than half (58 percent) of U.S. primary doctors said their patients often have difficulty paying for medications and care and 50 percent of the doctors said they spend substantial time dealing with restrictions insurance companies place on their patients’ care.

Most U.S. primary care doctors (69 percent) said their practices do not have provisions for after-hours care, forcing patients to seek care in emergency departments. Only 46 percent of U.S. doctors use electronic medical records, compared to 99 percent of doctors in the Netherlands and 97 percent of doctors in New Zealand and Norway.

Davis said universal coverage should come with a set of benefits, emphasizing primary care and prevention to help remove financial barriers and support primary care. Simplifying insurance to reduce complexity and paperwork for doctors and their staff is vital, too.

Country-specific information and an online tool to create charts and tables using Commonwealth Fund international survey data from 2006-2009 are available at

Address: Commonwealth Fund, 1 East 75th Street, New York, NY 10021; (212) 606-3800,

  This article was taken from:
Pay-for-Performance Reporter

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