The United States lags behind other countries in terms of adoption of health information technology, providing financial incentives for quality, and improving overall access to care, according to findings from a survey of primary care physicians in 11 countries.
These deficits in primary care, health information technology (HIT), and access have led to lesser quality of care in the United States in several areas compared with other countries, Commonwealth Fund President Karen Davis, Ph.D., said during a teleconference in announcing the results of her organization's International Health Policy Survey.
The survey, results of which were published online in the journal Health Affairs (2009;28:w1171-83), found that 58% of U.S. primary care physicians said their patients often have difficulty paying for medications and care, compared with 5%–37% of patients in the other countries studied.
In addition, 71% of U.S. physicians reported that their practices do not have provisions for after-hours care, forcing patients to seek care in emergency departments, the survey showed. Of the other countries studied, at least half of physicians in all but two countries (Norway and Canada) said they have provisions for after-hours care.
U.S. physicians also were far less likely than their international peers to use HIT—only 46% of U.S. doctors use electronic medical records, compared with 99% of physicians in the Netherlands and 97% of physicians in New Zealand and Norway, the survey showed.
Meanwhile, other countries are jumping ahead in implementing the patient-centered medical home approach, she said. “The concept … originated in the United States, but we found that such efforts are spreading faster in other countries,” Ms. Schoen said.
For example, all but two other countries provide a greater percentage of physicians with financial incentives for providing needed chronic or preventive care services or implementing other aspects of the medical home model, the survey showed.
For the study, Commonwealth Fund authors surveyed more than 10,000 primary care physicians in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States.
Data were collected from February through July 2009.