The Commonwealth Fund Study
The Commonwealth Fund recently released a study comparing primary care in the United States to 10 other high-income countries. The findings reveal significant shortcomings in the US system, particularly in access to care, continuity of care, and affordability.
Key Findings:
- Access to Care: The US ranked last among the 11 countries in access to care. This is largely due to high out-of-pocket costs, limited availability of primary care providers, and long wait times for appointments.
- Continuity of Care: Americans are less likely to have a consistent relationship with their primary care provider compared to their counterparts in other countries. This lack of continuity can lead to fragmented care and poorer health outcomes.
- Affordability: Healthcare costs in the US are significantly higher than in other developed countries. This is a major barrier to access for many Americans, particularly those with low incomes.
Comparison Tables:
| Country | Access to Care | Continuity of Care | Affordability |
|---|---|---|---|
| United States | 11th | 11th | 11th |
| Australia | 2nd | 3rd | 7th |
| Canada | 3rd | 2nd | 5th |
| France | 1st | 1st | 6th |
| Germany | 4th | 4th | 4th |
| Netherlands | 5th | 5th | 3rd |
| New Zealand | 6th | 6th | 10th |
| Norway | 7th | 7th | 2nd |
| Sweden | 8th | 8th | 1st |
| Switzerland | 9th | 9th | 8th |
| United Kingdom | 10th | 10th | 9th |
A Look at the Numbers:
Here’s few comparisons of the provided data:
- Long-Term Relationships:
- US: 43% of patients see the same primary care physician (PCP) for over 5 years.
- Germany: 71% of patients see the same PCP for over 5 years.
- House Calls:
- US: 37% of PCPs make house calls.
- UK: 97% of PCPs make house calls.
- After-Hours Access:
- US: 45% of PCPs offer after-hours access to patients.
- Germany: 96% of PCPs offer after-hours access to patients.
- Integrated Care:
- US: 33% of primary care practices offer on-site mental health services.
- Sweden/Netherlands: 94% of primary care practices offer on-site mental health services
| Country | Primary Care Spending as % of Total Health Expenditure |
|---|---|
| United States | 4.7% |
| Australia | 13.9% |
| Canada | 14.1% |
| France | 15.4% |
| Germany | 14.9% |
| Netherlands | 15.2% |
| New Zealand | 14.4% |
| Norway | 14.5% |
| Sweden | 14.7% |
| Switzerland | 12.3% |
| United Kingdom | 14.1% |
Conclusion:
The Commonwealth Fund study highlights the urgent need for reforms to the US primary care system. Increasing access to affordable care, improving continuity of care, and strengthening the primary care workforce are critical steps towards improving health outcomes for all Americans
