Fw: Study Ranks U.S. Last in Healthcare Performance

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[cancercure] Study Ranks U.S. Last in Healthcare Performance

Medical News: Study Ranks U.S. Last in Healthcare Performance

The U.S. healthcare system continues to rank behind the systems in other

developed countries, according to a report from the Commonwealth Fund.

On all five main performance categories -- quality, efficiency, equity,

access, and long, healthy, and productive living -- the U.S. ranked either

last or next to last compared with Australia, Canada, Germany, the

Netherlands, New Zealand, and the U.K.

Overall, that put the U.S. at the bottom of the list, despite spending

substantially more on healthcare than the other countries. The Netherlands

was ranked first overall.

" On many measures of health system performance the U.S. has a long way to

go to perform as well as other countries that spend far less than we do on

healthcare yet cover everyone, " said , PhD, president of the

Commonwealth Fund, on a conference call with reporters.

" It's disappointing but not surprising that despite our significant

investments in healthcare, the U.S. continues to lag behind other countries, "

she said.

But was hopeful that the implementation of the healthcare reform

law would start to turn things around, improving access, quality, and

efficiency.

" Our hope and expectation is that when the law is fully enacted we will

match and even exceed the performance of other countries, " she said.

The report, which updates three previous editions also finding the U.S.

trailing its peers, was based on annual surveys of patients and physicians

by the Commonwealth Fund from 2007 to 2009, as well as data from the World

Health Organization and the Organization for Economic ation and

Development.

That information showed that, in terms of per capita health expenditures,

the U.S. was spending the most, at $7,290 in 2007. The next highest was

Canada, at $3,895. The lowest was New Zealand, at $2,454.

Health expenditure as a percentage of gross domestic product was also

highest in the U.S. (16%); it was lowest in the U.K. (8%).

But expenditures notwithstanding, and her colleagues ranked the

Netherlands as having the best-performing healthcare system, followed by the

U.K., Australia, Germany, New Zealand, Canada, and the U.S.

The U.S. was last exclusively in terms of efficiency, equity, and healthy

living, tied with Australia for last in access to care, and second to last

in front of Canada in quality.

Examples of specific measures addressed in each of the five performance

categories are as follows:

* Quality - The U.S. had the highest percentage of adults who were

given either the wrong medication or the wrong dose in the past two years

(14%). The Netherlands (6%) and the U.K. (9%) had the lowest proportions.

* Access - More than half of U.S. survey respondents (54%) reported

having a problem accessing needed care because of cost. The next highest

percentage was in Australia (36%) and the lowest rate was in the Netherlands

(7%).

* Efficiency -- One-fifth of sicker adults in the U.S. said they had

been sent for duplicate tests by different physicians in the past two

years. That compares with 7% in the U.K. and 4% in the Netherlands.

* Equity -- The disparity between high-income individuals and

low-income individuals in not filling a prescription or skipping doses because

of cost was widest in the U.S., at 20 percentage points. New Zealand's gap

was similarly high at 16 percentage points. There was no such gap in the

Netherlands. The difference was 7 percentage points in the U.K. and Germany.

* Long, healthy, and productive lives -- The U.S. had the highest

death rate before age 75, when mortality is potentially preventable. It had

110 deaths per 100,000 population, compared with 103 in the U.K. (the next

highest) and 71 in Australia (the lowest). The U.S. was also worst in

infant mortality and second to last in healthy life expectancy at age 60.

" These findings are clearly disappointing for U.S. patients and their

families, " said on the conference call.

But the newly passed healthcare reform law has the potential to transform

and improve the system, she said.

According to , the law will increase insurance coverage and

affordability, slow the rise in healthcare costs for individuals and families,

and

promote a stronger primary care foundation, health information technology,

and quality and safety initiatives.

Primary source: Commonwealth Fund

Source reference:

_ K, et al " Mirror, mirror on the wall: how the performance of the

U.S. healthcare system compares internationally " Commonwealth Fund 2010;

Publication Number 1400._

(http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2010/Jun/Mirr\

or-Mirror-Update.aspx)

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