U.S. spends most, but health quality lags

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Thu Nov 5, 2009 12:32am EST

By Steenhuysen

CHICAGO (Reuters) - Americans are more likely than people in 10 other countries

to have trouble getting medical treatment because of insurance restrictions or

cost, an international survey of primary care doctors released on Wednesday

found.

While the United States spends more than twice as much as other developed

countries on healthcare, it lags well behind in key measures of quality, the

annual survey found.

" Our weak primary care system puts patients at risk and results in poor health

outcomes and higher costs, " said , president of the Commonwealth

Fund, a private health policy group that sponsored the survey.

" The survey provides yet another reminder of the urgent need for reform that

makes acceptable, high-quality care a national priority, " told a news

briefing.

Other countries have solved problems the United States is still struggling to

conquer, she said.

The survey of more than 10,000 primary care doctors in 11 developed countries --

Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway,

Sweden and the United Kingdom -- found problems in all of them.

In the United States, cost and access to care stood out as a major challenge for

primary care doctors.

" 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, " Schoen of the Commonwealth Fund, whose study

appears in the journal Health Affairs, told the briefing.

Paying for healthcare was a problem in 5 to 37 percent of other countries

surveyed.

Insurance restrictions, such as provisions to limit or control medication or

treatment, are a major impediment for U.S. doctors, with half of 1,400

physicians surveyed saying the time they and their staff spend dealing with

insurance companies is a major problem.

The survey from February to July 2009 was conducted by mail, online and by

phone.

AFTER HOURS

" 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, " Schoen said.

The survey also asked doctors if patients in their country could see a doctor

after regular business hours without being forced to go to the emergency room.

Nearly all doctors surveyed from the Netherlands, New Zealand and the United

Kingdom said this was offered, compared with just 29 percent of doctors in the

United States -- which ranked lowest in the survey. 

" The vast majority say they have no arrangement at all, " Schoen said, adding

that the 29 percent figure is a drop from 40 percent reported in 2006.

By contrast, doctors in the United States and Britain were least likely to say

their patients faced long waits to see a specialist, compared with Canadian and

Italian doctors, who were most likely to say this was a problem.

The study also shows the United States and Canada trail other developed

countries in the use of basic electronic medical records. 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 findings underscore the extent to which national policies matter, " Schoen

said.

http://www.reuters.com/article/GCA-HealthcareReform/idUSTRE5A40L720091105