More than half U.S. chronically ill forgo care

NEW YORK – U.S. residents with chronic diseases are much likelier to forgo needed medical care because of the cost than their counterparts in other developed nations, and they’re also likelier to experience medical errors, a study published last week shows.
The study, conducted by the Commonwealth Fund and published online in the journal Health Affairs (content.healthaffairs.org), involved a survey of 7,500 adults, each with at least one of seven chronic diseases – high blood pressure, heart disease, lung disease, diabetes, cancer, arthritis and depression – in Australia, Canada, France, Germany, the Netherlands, New Zealand, the Britain and the United States.
Fifty-four percent of the U.S. patients didn’t get recommended care, fill prescriptions or see a doctor when sick because of costs, the study found, versus 7 to 36 percent in the other countries. In addition, 41 percent of the Americans said they spent more than $1,000 out of pocket on medical costs last year, while in Britain, out-of-pocket costs hit that level for only 4 percent, and in the Netherlands, for 8 percent.
The study also found 34 percent of U.S. patients experienced medical errors or poorly coordinated care, such as duplicate tests, unavailable test results and delays in the availability of medical records; in some countries, the problems were half as common.
And only 26 percent of U.S. and Canadian patients reported same-day access to doctors when sick, and one-fourth or more reported long waits, while same-day appointments were available to 60 percent of Dutch, 54 percent of New Zealand, and 48 percent of British patients.
“Lack of affordable access, waits for primary care, and inadequate coordination put chronically ill U.S. patients – especially those with multiple chronic conditions – at high risk of poor health outcomes,” the study says. “Notably, despite spending much more, the United States has been falling behind all of the other surveyed countries in reducing premature deaths from conditions amenable to health care.”
The study also found that uninsured U.S. patients were particularly at risk for these problems, with 82 percent forgoing recommended care or skipping medications because of the cost. But the insured aren’t doing that well, either: 43 percent of those who were insured all year skipped care because of costs, well above rates in other countries.
“The United States is not only facing an economic crisis, we are facing a health system crisis,” said Commonwealth Fund President Karen Davis in a news release. “Our leaders need to come together to develop reforms which will make lasting improvements for patients, to assure universal coverage and high quality, efficient care. With the United States outspending all other countries, we can’t afford not to reform our health care system to secure a healthier future.”
The Commonwealth Fund is a private foundation supporting independent research on health policy reform and a high-performance health system. For more information, go to www.commonwealthfund.org.

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