The Quality of U.S. Health Care, Part Three

I’m on a roll, so I might as well stick with international comparisons before moving off in other directions. The Commonwealth Fund has done an ongoing survey of health care parameters since 2004  (updated 2007) entitled, “Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care.” A catchy, but then academic title – don’t you think? Regardless, the study uses data from surveys of both patients and primary care physicians regarding their views of medical practices in their own country. The survey compares Australia, New Zealand, Canada, Germany, the U.K., and the U.S on six measures: Quality Care (right care, safe care, coordinated care, patient-centered care), Access, Efficiency, Equity, and Healthy Lives. Unfortunately, we ranked last or an only slightly less troubling next to last on all five measures. The one promising spot was that under Quality Care we ranked first for “Right Care,” meaning that our doctors know what they are doing.  Now again a part of this is the difference between having universal health coverage and not.  You obviously cannot score very well under Access and Equity when a large proportion of your population has neither.  The Healthy Lives category is of particular interest.  They looked at death rates of diagnosis that are treatable.  The U.K. and the U.S. had death rates 25%-50% higher than the other countries.  Again, this could be a result of the lack of universal health care as those without access do not get treatment or get treatment too late. Another area that stood out was the lag in information technology in the U.S., and in the same light, coordinated care.  Maybe that has something to do with our poor safety marks as well.  To end on a good note the U.S. scored well on preventive care.

This study dives in much deeper than I am presenting it.  There are tons of charts, graphs, and so forth that anyone can look at, and of course, it is more nuanced than I have space.  But the overall picture is that we are not doing so well compared to our good friends to the north, across the Atlantic, and even down under.


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