|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’
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,
Country-specific information and an online tool to
create charts and tables using Commonwealth Fund international survey
data from 2006-2009 are available at www.commonwealthfund.org/Topics/International-Health-Policy.aspx
Address: Commonwealth Fund, 1 East 75th Street, New York, NY 10021; (212) 606-3800, www.commonwealthfund.org.