Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments

Which Patients Are Happiest With The Care They Receive?

Adults who received care from a medical home in 11 Westernized countries were less likely to report medical errors and were happier with their care, according to a new Commonwealth Fund international survey.

The 2011 survey included more than 18,000 ill adults in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. It included people who reported they were in fair or poor health, had surgery or had been hospitalized in the past two years, or had received care for a serious or chronic illness, injury or disability in the past year. The vast majority had seen multiple physicians.

A medical home was defined as patients reporting a regular source of care that knows their medical history, is accessible and helps coordinate care received from other providers. Results were published in Health Affairs.

Sicker adults in the U.S. were the most likely to have problems paying medical bills. More than 42% reported not visiting a doctor, not filling a prescription, skipping doses or not getting recommended care. U.S. rates of forgone care because of cost were at least double the rates in every other country except Australia, New Zealand, and Germany.

Also in the U.S., 27% said they could not pay or had serious problems paying medical bills, compared with between 1% and 14% of adults in the other 10 countries. And, 36% spent more than $1,000 on medical costs, compared with fewer than 10% in France, Sweden, and the U.K., the countries with the lowest rates.

Patients reporting medical errors, such as prescription- and lab-test errors, ranged from a low of 8% to 9% in the U.K. and Switzerland to 22% or more in New Zealand, Norway and the U.S.

When asked about seeking non-emergency care during evenings and weekends without going to the emergency department, more than half of the sicker adults in Canada, Australia, the United States, France, and Sweden reported difficulty. Swiss and UK patients were the least likely to report difficulty gaining access after hours, followed by those in The Netherlands and Norway.

In all eleven countries one-third or more of the sicker adults had visited the emergency department in the past two years, since these facilities play a role in treating sicker patients. About half or more of patients in Canada, Sweden, the United States, Australia and New Zealand were significantly higher than use rates in the other countries. Canadian patients reported the highest use rates, which probably reflects the lack of after-hours alternatives, the authors wrote.

Gaps also emerged in all countries at the point of hospital discharge, with at least one in four patients indicating lack of follow-up instructions or arrangements or clear medication directions. U.S. patients reported among the lowest rates of gaps in coordination of hospital discharge, perhaps reflecting intensified payer and policy focus on discharge planning to lower readmission rates, the authors wrote. U.S. patients also have shorter hospital stays, meaning they may also be sicker and more in need of coordination to ensure appropriate transitional care after discharge.

*This blog post was originally published at ACP Internist*

You may also like these posts

    None Found

Read comments »

Comments are closed.

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »