The U.S. performed poorly on most dimensions of primary care, with the exception of clinical preventive care, compared with four other industrialized countries, according to a Web exclusive report for the journal Health Affairs.
The report, based on 2004 surveys of adults in the U.S., Australia, Canada, New Zealand and the U.K., found that adults in the U.S. reported the highest personal healthcare costs. Out-of-pocket spending exceeded $1,000 in the past year for more than 25% of U.S. respondents, compared with 14% of Australians, 12% of Canadians, 5% of New Zealanders and 4% of U.K. respondents. And U.S. adults were most likely to say they did not see a doctor when sick.
In addition to cost-related access concerns, short-term physician relationships were particularly a problem in the U.S., the report by Commonwealth Fund researchers said.
Surveys indicated that failures to communicate, engage patients or promote health were widespread across the countries' healthcare systems. The U.S. tended to "lead or rank high among countries" in clinical preventive care, with U.S. women, for example, most likely to be screened for cervical cancer according to prescribed guidelines.
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