11-country survey of older adults: Americans sicker but have quicker access to specialists

This study was supported by The Commonwealth Fund and also will appear in the December issue of Health Affairs.

The study surveyed 15,617 adults ages sixty-five and older in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States.

Some other key findings:

- Only 57 percent of American respondents could get same-day or next-day medical appointments when sick. This was lower than many countries (83 percent in France and New Zealand and 81 percent in Germany) but higher than Canada (45 percent).

- Regarding getting specialty care appointments, the reverse was found: Eighty-six percent of Americans reported waiting less than four weeks, better than any other country except Switzerland (82 percent).

- In the area of care coordination, Americans were the most likely (23 percent) to report that test results or records were not available at doctors' appointments or duplicate tests had been ordered. However, in assessing post-hospitalization care, Americans were among the least likely (28 percent) to have experienced gaps in discharge planning.

This is the seventeenth in a series of international survey analyses from this group of authors. However, past surveys have assessed the health and health care of general populations, where, according to the authors, "the United States has been the outlier...for its high numbers of uninsured people and the absence of national standards for essential benefits or financial protection." This survey of an older population, with near-universal coverage of Americans by Medicare or some other health insurance, allowed the authors "to compare more directly the performance of the US health care delivery system with...other industrialized nations."