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Survey: Americans get deficient health care

Full story:

http://seattletimes.nwsource.com/html/nationworld/2002603067_healthcare04.html

By Rob Stein

The Washington Post

WASHINGTON -- Americans pay more when they get sick

than people in other Western nations and receive

more confused, error-prone treatment, according to

the largest survey to compare U.S. health care to

that of other nations.

The survey of nearly 7,000 sick adults in the United

States, Australia, Canada, New Zealand, Britain and

Germany found Americans were the most likely to pay

at least $1,000 in out-of-pocket expenses. More than

half went without needed care because of cost, the

survey found, and more than one-third endured

mistakes and disorganized care when they did get

treated.

While patients in every nation sometimes run into

obstacles to getting care and deficiencies in

treatment, the United States stood out for having

the highest error rates, most disorganized care and

highest costs, the survey found.

" What's striking is that we are clearly a world

leader in how much we spend on health care, " said

Schoen, senior vice president for The

Commonwealth Fund, a private, nonpartisan, nonprofit

foundation based in New York that commissioned the

survey. " Clearly, we should be doing better. "

Other experts agreed, saying the results offer the

most recent evidence that the quality of care

delivered by the U.S. system is seriously eroding as

health-care costs soar.

" This provides confirming evidence for what more and

more health-policy thinkers have been saying, which

is, 'The American health-care system is quietly

imploding, and it's about time we did something

about it,' " said Lucian Leape of the Harvard School

of Public Health.

The new survey, the eighth in an annual series of

cross-national surveys conducted by

Interactive for the foundation, is the largest to

examine health-care quality across several nations

during the same period.

The survey, published in the journal Health Affairs,

questioned 6,957 adults who had recently been

hospitalized, undergone surgery or reported health

problems between March and June this year.

" These patients are the canary in the coal mine of

any health-care system, " Schoen said.

Nearly a third of U.S. patients reported spending

more than $1,000 in out-of-pocket expenses for care.

Canadians and Australians came next, with 14 percent

of patients spending that much. The proportion

reporting similarly high costs was far lower in the

other countries.

Americans also were more likely to report forgoing

needed treatment because of cost. About half of

Americans said they had decided not to fill a

prescription, see a doctor when they were sick or

get recommended follow-up tests. About 38 percent of

patients in New Zealand reported going without care,

as did 34 percent in Australia, 28 percent in

Germany, 26 percent in Canada and 13 percent in

Britain.

About one-third of U.S. patients reported problems

with the coordination of their care, such as when

test results were not available at the time of their

doctor's appointment or when doctors ordered

duplicate tests. In the other countries, between 19

percent and 26 percent of patients reported similar

problems.

Americans also reported the greatest number of

medical errors. Thirty-four percent reported getting

the wrong medication or dose, incorrect test

results, a mistake in their treatment or care, or

being notified late about abnormal test results.

Thirty percent of Canadian patients, 27 percent of

Australian patients, 25 percent of New Zealanders,

23 percent of Germans and 22 percent of Britons

reported errors.

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