United States Ranks Lowest for Quality Care

Despite reform and shifts in health policy, the United States healthcare system ranked last in quality compared with 10 other industrialized counties—just as it did in 2010, 2007, 2006, and 2004. The Commonwealth Fund, which compiled the report, also determined that US spending per capita was $8508. This is far more expensive than the second-most costly system in Norway—which spends $5669 per capita.

“Although the US spends more on healthcare than any other country and has the highest proportion of specialist physicians, survey findings indicate that from the patients” perspective, and based on outcome indicators, the performance of American healthcare is severely lacking,” read the report.

Other findings in the report focused on 5 main areas: quality, access, efficiency, equity, and quality of life. Compared with 10 other countries, the United States:

• Fared best on provision and receipt of preventive and patient-centered care. However, they received lower scores on safety and coordination. “Continued adoption of health information technology should enhance the ability of US physicians to identify, monitor, and coordinate care for their patients, particularly those with chronic conditions,” determined the report.
• Ranked low on access due to problems related to cost. “Patients in the United States have rapid access to specialized healthcare services; however, they are less likely to report rapid access to primary care than people in leading countries in the study,” explained the report. “In other countries, like Canada, patients have little to no financial burden, but experience wait times for such specialized services.”
• Received poor performance for its measures of national health expenditures and administrative costs as well as on its measures of avoidable emergency room use, and duplicative or unnecessary medical testing.
• Ranked lowest on its measure of equity. Low-income Americans are more unlikely to seek care when they are sick due to associated costs versus low-income individuals in other countries.
• Received poor ratings for mortality rates—including infant mortality—and healthy life expectancy at age 60 years.

The Commonwealth Fund noted that while the Affordable Care Act has begun to implement some of the processes necessary for greater quality healthcare in the United States, there are still many changes that should be made.

“Many US hospitals and health systems are dedicated to improving the process of care to achieve better safety and quality, but the United States can also learn from innovations in other countries—including public reporting of quality data, payment systems that reward high-quality care, and a team approach to management of chronic conditions,” read the report. “Based on these patient and physician reports, and with the enactment of health reform, the United States should be able to make significant strides in improving the delivery, coordination, and equity of the health care system in coming years.”

Around the Web

Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationally [The Commonwealth Fund]