U.S. Healthcare Stats Compared To Other Delivery Systems - 2004

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2004 Survey Comparing HealthSystems

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<ul><li> 1. THE COMMONWEALTH FUNDThe Commonwealth Fund 2004 International Health Policy Survey ofPrimary Care in Five CountriesCathy Schoen and Robin Osborn </li></ul> <p> 2. 2004 International Health Policy Survey Topics: System Views, Access, Doctor-Patient Communication, Coordination, Emergency Room Care, Prescription Drugs, Preventive Care, and Chronic Illness Management Telephone survey of 1,400 adults ages 18 and older in Australia, Canada, New Zealand, the United States, with an expanded sample of 3,061 in the United Kingdom (funded by The Health Foundation) Conducted by Harris Interactive and subcontractors March 29 to May 17, 2004. Margin of error + or - 3 percentage points for differences between countries and + or - 2% for country averages THE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 3. Views of the Health Care System 4. Views of The Health Care System in Five Nations - 1998 to 2004 Percent saying:AUSCAN NZ UK USOnly Minor Changes Needed20042121 19 261620012521 18 211819981920 92517 Rebuild Completely20042314 19 133320011918 20 182819983023 32 1433THE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 5. Access to Care 6. Length of Time with RegularDoctor/Place of CarePercent:AUS CAN NZ UK USHas Regular Doctor/Place949597 99 91 2 years or less222021 18 29 3-5 years222120 17 25More than 5 years505356 63 37 No regular doctor/place 55 319 THE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 7. Access to Doctor When Sick or NeedMedical AttentionPercent756054 50 4133 272525 1913 720AUS CAN NZ UK US AUS CAN NZ UK US Same day appointmentWait of 6 days or moreTHECOMMONWEALTH 2004 Commonwealth Fund International Health Policy SurveyFUND 8. Difficulty Getting Care on Nights, Weekends, Holidays Without Going to The ERPercent Saying Very or Somewhat Difficult 75 63 5954 5043 3325 0 AUS CAN NZUK US THE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 9. Called Help Line for Medical Advice in the Past 2 YearsPercent50282425178 80 AUS CANNZ UK US THE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 10. Out-of-Pocket Medical Costs Percent in the Past Year 75 5750 2622 25 14 121011 7 5 40 AUS CAN NZ UK USAUS CAN NZ UK US No out-of-pocket cost More than US $1,000 THE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 11. Cost-Related Access ProblemsPercent in the pastAUS CANNZ UK US year who due to cost: Did not fill prescription129 11 422 or skipped doses Had a medical problem but did not 176 28 429 visit doctor Skipped test, 188 20 227 treatment or follow-up Percent who said yes to at least one of the29 17 34 940 aboveTHE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 12. Going without Needed Care Due to Costs,Total and Low Income Percent went without care due to cost 75575044 40 34352926 251712 9 0 AUS CAN NZ UK US AUS CAN NZ UK US All AdultsAdults with BelowTHEAverage IncomesCOMMONWEALTH 2004 Commonwealth Fund International Health Policy SurveyFUND 13. Satisfaction in Amount of Choice YouHave in Doctors You See Percent:AUS CAN NZ UK US Very satisfied403048 44 39 Somewhat satisfied 404037 35 39Not very or not 172712 18 20 at all satisfied THECOMMONWEALTH 2004 Commonwealth Fund International Health Policy SurveyFUND 14. Wanted Information on Quality of Care Doctor Provides When Had to See a New Doctor Percent saying Yes 7556504028 24 25180 AUS CANNZ UK US THE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 15. Access to Own Medical Records Percent:AUS CANNZ UK US Currently have access4034 45 28 51Do not have access:Would like access4048 35 42 37Dont want access1715 15 25 10THECOMMONWEALTH 2004 Commonwealth Fund International Health Policy SurveyFUND 16. Email Communication with Doctor Base: Have regular doctor/placePercent: AUSCAN NZ UK USCurrently can email doctor16 1022 13 20Have internet, cannot currently email doctor:Would like to be able to15 2818 27 25 emailWould not like to be43 3940 37 33 able to email Do not have access to24 2119 21 21 internetTHE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 17. Emergency Room Use and Experiences 18. Emergency Room Use in the Past 2 Years Percent with any visits50383429 2927 25 0 AUS CANNZ UK US THE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 19. Went to the ER for a Condition That Could Have Been Treated by Regular Doctor ifAvailable Percent 50 25 18 169 760 AUSCAN NZUK US THE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 20. Waited 2 Hours or More in ER BeforeBeing Treated Base: Adults with ER visit in past 2 yearsPercent48 5036 342927 250AUS CAN NZUK US THE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 21. ER Staff Did Everything They Could to Help Control PainBase: Adults with ER visit in the past 2 years and in pain Percent 504850 37 31 33250AUSCAN NZUK US THE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 22. Rated Overall Quality of Emergency Care Services as Fair or PoorBase: Adults with ER visit in the past 2 years Percent50 34 27 272323250 AUSCANNZ UK US THECOMMONWEALTH2004 Commonwealth Fund International Health Policy Survey FUND 23. Doctor-Patient Relationship and Communication 24. Doctor-Patient RelationshipPercent saying doctor: AUS CANNZ UKUSAlways listens 7166 74 6858carefullyAlways explains things 7370 73 6958so you can understandAlways spends enough 6355 66 5844time with you THECOMMONWEALTH 2004 Commonwealth Fund International Health Policy SurveyFUND 25. Missed Opportunities to Engage Patient in CarePercent saying AUS CANNZ UK USdoctor:* Does NOT give you 1012 813 13clear instructions Does NOT make goals 1415 13 19 20and plans clearDoes NOT tell youabout treatment 3535 30 50 44choices or ask youropinions*Doctor only sometimes, rarely or never THECOMMONWEALTHFUND2004 Commonwealth Fund International Health Policy Survey 26. Left Doctors Office Without Getting Important Questions AnsweredPercent unanswered questions in past two years 5024 22 25 19 20 13 0 AUS CAN NZUK US THE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 27. Have NOT Followed Doctors Advice orTreatment Plan in Past 2 Years Percent 50 31 2826 22 25 14 0 AUSCANNZUK USTHE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 28. Areas of Patient Non-AdherenceBase: Respondents who have not followed doctors advicePercent who: AUS CAN NZ UKUS Did NOT take medicines as 383549 48 35prescribedDid NOT follow advice ondiet, smoking, drinking or 334024 24 37other lifestyle changesDid NOT get follow-upappointment or see 101014 713specialistDid NOT get diagnostic testor have recommended11 77911surgery or procedureTHE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 29. Main Reasons for Non-Adherence Base: Respondents who have not followed doctors advice Percent saying:AUS CANNZ UK USDisagreed withrecommendation 3521 37 43 30 Too difficult to do3228 28 26 34 Cost too much811 14 118 Condition improved815 484Concerned aboutrisks/side effects32635 Did not understand210 252what to do THECOMMONWEALTH 2004 Commonwealth Fund International Health Policy SurveyFUND 30. Coordination 31. Care CoordinationBase: Have seen a doctor in past 2 years Percent saying in the past 2 AUS CAN NZ UKUSyears:Test results or records notavailable at time of12 1413 1317appointmentDuplicate tests: doctorordered test that had already7674 14been doneReceived conflictinginformation from different18 1414 1418doctorsPercent who experienced at28 2625 2431least one of the aboveTHE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 32. Prescription DrugsBase: Adults taking prescriptions regularlyPercent saying inthe past 2 yearsAUS CAN NZ UK USdoctor:Has NOT reviewedthe medications you 29 25 31 37 25takeHas NOT explainedthe side effects of 25 28 27 39 30medications% who said doctorhas not done one of 42 39 42 55 41the above THE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 33. Did Not Receive Lab Tests/X-Ray Results or Results Not Clearly ExplainedBase: Have seen a doctor in past 2 yearsPercent 283022 21 20201610 0 AUSCAN NZ UK US THE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 34. Given Incorrect Test Results or Delays inBeing Notified about Abnormal Results Base: Adults with test in past 2 yearsPercent 3020 14 1512 9 8 10 0AUS CANNZUK US THE COMMONWEALTH FUND 2004 Commonwealth Fund International Health Policy Survey 35. Lack of Hospital and ER Coordination Base: Have regular doctor/place and hospitalized or used ER in past 2 yearsPercent sayingAUS CAN NZ UK US regular doctor:Was NOT well informed about plans19 21 23 23 13 for follow-up care after hospital Was NOT well informed about the30 36 28 32 30 care you received in the ERTHE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 36. Preventive Care 37. Do NOT Receive Reminders forPreventive Care Percent75 626155 50 4950 25 0AUS CAN NZ UK US THE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 38. Missed Opportunities to Promote Health Base: Have regular doctor/place of carePercent said in past 2 AUS CANNZ UK US years doctor:Has NOT provided advice on weight, 6255 67 7248 nutrition or exercise Has NOT asked if any emotional issues may 6762 71 7263 be affecting your health THECOMMONWEALTH 2004 Commonwealth Fund International Health Policy SurveyFUND 39. Adults with Chronic Condition: DoctorDid NOT Give Plan for Self-Management Base: Adults with chronic disease Percent75 55 5043403736 250 AUS CANNZ UK US THE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 40. Preventive Care Percent received:AUSCAN NZ UK USPap in past 3 years, age 25-64 78 7781 77 89Mammogram in past 3 years, age80 7981 77 86 50-64Flu shot in past year, age 65+77 6667 74 72 THE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND 41. Summary and Implications Primary care shortfalls in all countries. Gaps in patient-centered care, access, safety andcoordination of care. Access concerns in all countries, but notable country variations on wait to see doctor and cost. Lack of prompt access to doctor linked to higher ER usein U.S. and Canada. Cost sharing can undermine timely care. Safety and risks in ambulatory care a challenge. Includes prescription drugs reviews and diagnostic tests. Missed opportunities for preventive care. Issues amenable to policy action. THE COMMONWEALTH FUND 2004 Commonwealth Fund International Health Policy Survey 42. Country Initiatives 24/7 Access to Care NHS Direct (U.K.) After-hours Primary Medical Care Program (Australia) Primary Care Transition Fund (Canada) Incentives for Quality and Primary Care GP Contract (U.K.) Primary Health Organizations (New Zealand) CMS Doctors Office Quality, P4P, Leapfrog (U.S.) Collaboratives Information Technology (EMR+) National Programme for IT (U.K.) Canada Health Infoway THE COMMONWEALTH 2004 Commonwealth Fund International Health Policy Survey FUND </p>