Monday, November 9, 2009

U.S. Should Focus on Primary Care

A new study conducted by the Commonwealth Fund was published by Health Affairs and it showed that the U.S. lagged behind other nations in some very important ways that affect health and access to quality health care. The study surveryed over 10,000 primary care physicians in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States. The study found that:

  • The vast majority (69 percent) of U.S. respondents report that their practices have no provisions for after-hours care, leaving their patients no choice but the emergency room. The U.S. was behind every other country surveyed on this finding.

  • Fifty-eight percent of U.S. primary care physicians say their patients often have trouble paying for their medications and care, compared to 5- 37 percent in the other ten countries.

  • While 99 percent of doctors in the Netherlands and 97 percent of doctors in New Zealand and Norway use electronic medical records (EMRs), only 46 percent of U.S. doctors report EMR use.

  • One-third of U.S. physicians report receiving any financial incentives for the quality improvement measures tracked in the survey. By contrast, 89 percent of doctors in the U.K. and sizable majorities of their counterparts in the Netherlands, New Zealand, Italy, and Australia report financial incentives tied to quality.

Primary care forms the foundation of a quality health delivery system, coordinating care and holding down prices.

The authors conclude, "Overall, the survey highlights the lack of national policies focused on U.S. primary care. Unless primary care practices are part of more integrated care systems, they are on their own facing multiple payers with uncoordinated policies. In contrast, other countries with multiple payers seek coherent payment and coverage policies. As the United States looks to develop new primary care models that could work well for patients and physicians, policymakers can learn a great deal from diverse initiatives under way in other countries."


jobb said...

Too bad Congress has so many concerns to consider with the new Health Care Bill now being formed. Hopefully more accommodations for Primary Care
issues can be introduced wherever they can be utilized.

Toni Brayer MD said...

jobb: Unfortunately, without the focus on fixing the primary care issues, we will never be able to harvest the benefits of reform. More people insured with less access to physicians means higher costs, more use of ERs and lots of specialists doing tests and procedures on conditions that should have been coordinated. Fix Primary Care while Health Care Reform is being designed.

Robin said...

Amen said...

Hey, there's a lot of helpful information here!

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