November 5, 2009

US Spends More On Health Care, But Quality Falls Short

An international survey of primary care doctors released on Wednesday found that Americans are more likely than people in 10 other countries to have trouble getting medical treatment because of insurance restrictions or cost, Reuters reported.

The annual survey, conducted from February to July 2009 by mail, online and phone, found that while the United States spends more than twice as much as other developed countries on healthcare, it stills lags well behind in key measures of quality.

Karen Davis, president of the Commonwealth Fund, a private health policy group that sponsored the survey, said our weak primary care system puts patients at risk and results in poor health outcomes and higher costs.

"The survey provides yet another reminder of the urgent need for reform that makes acceptable, high-quality care a national priority," Davis said.

She added that other countries have solved problems that the United States is still struggling to conquer.

The survey found issues in all of the more than 10,000 primary care doctors in 11 developed countries, including Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden and the United Kingdom.

Cost and access to care stood out as a major challenge for primary care doctors in the United States.

Cathy Schoen of the Commonwealth Fund, whose study appears in the journal Health Affairs, said the majority of U.S. doctors -- some 58 percent -- say their patients often have difficulty paying for medications and other medical care, by far the highest rate in the survey.

Some 5 to 37 percent of other countries surveyed listed paying for healthcare as a problem.

One major impediment for U.S. doctors is insurance restrictions, such as provisions to limit or control medication or treatment.

At least half of 1,400 physicians surveyed said the time they and their staff spend dealing with insurance companies is a major problem.

Schoen said it appears that U.S. doctors are adding staff to their offices that would not be typical of other countries just to cope with our complex, fragmented insurance system and advocate for their patients.

Doctors were also asked if patients in their country could see a doctor after regular business hours without being forced to go to the emergency room. Among doctors surveyed in the Netherlands, New Zealand and the United Kingdom, almost all said this was offered, compared with just 29 percent of doctors in the United States -- which ranked lowest.

Schoen said the vast majority have no arrangement at all, adding that the 29 percent figure is a drop from 40 percent reported in 2006.

However, doctors in the United States and Britain were least likely to say their patients faced long waits to see a specialist, while Canadian and Italian doctors were most likely to cite long waits as a problem.

The United States and Canada also trail other developed countries in the use of basic electronic medical records, the survey said.

It showed that less than half of U.S. doctors (46 percent) say they have electronic medical records, and just 37 percent of doctors in Canada have them. Electronic medical records are nearly universal in the Netherlands, New Zealand, the United Kingdom, Australia, Italy, Norway and Sweden.

The survey concluded that national policies have been instrumental in the leading countries to achieve round-the-clock access, information systems, and advance primary care teams.

"Overall, the survey highlights the lack of national policies focused on U.S. primary care. Unless primary care practices are part of more integrated care systems, they are on their own facing multiple payers with uncoordinated policies," it said.


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