The U.S. healthcare system ranks last compared with five other nations on measures of quality, access, efficiency, equity, and outcomes, according to the third edition of a Commonwealth Fund report analyzing international health policy surveys. Although the United States did well on some preventive care measures, the nation ranked at the bottom on measures of safe care and coordinated care.
Another new Commonwealth Fund report comparing health spending data in industrialized nations reveals that despite spending more than twice as much per capita on health care as other nations ($6,102 versus $2,571 for the median of Organization for Economic Cooperation and Development countries in 2004), the United States spends far less on health IT--just 43 cents per capita, compared with about $192 per capita in the United Kingdom.
In Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care, Karen Davis, PhD, and colleagues compare surveys on physicians’ and patients’ experiences and views of their health systems conducted in Australia, Canada, Germany, New Zealand, the United Kingdom, and the United States between 2004 and 2006. On access measures, the United States ranked last overall, including last on timeliness of care: 61% of U.S. patients said it was somewhat or very difficult to get care on nights or weekends, compared with 25% to 59% in other countries. The nation also ranked last overall in efficiency, including last on percent of patients who have visited the emergency department for conditions that could have been treated by a regular physician if one had been available (26% versus 6% to 21% in other countries). On measures of quality, the United States overall ranked fifth out of six countries.
“The United States stands out as the only nation in these studies that does not ensure access to health care through universal coverage and promotion of a ‘medical home’ for patients,” said Commonwealth Fund President Karen Davis. “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. In light of the significant resources we devote to health care in this country, we should expect the best, highest performing health system.”
