New International Survey: More Than Half of Chronically Ill U.S. Adults Skip Needed Care Due to Costs

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<p>A new <a href="/publications/in-the-literature/2008/nov/in-chronic-condition--experiences-of-patients-with-complex-health-care-needs--in-eight-countries--20
">Commonwealth Fund survey</a> of chronically ill patients in eight industrialized nations finds that those in the U.S. are by far the most likely to forgo care because of the cost, as well as the most likely to experience medical errors, care coordination problems, and high out-of-pocket costs.<br><br>According to the study, which also included Australia, Canada, France, Germany, the Netherlands, New Zealand, and the United Kingdom, U.S. patients are significantly more likely to call for fundamental change in their country's health care system, with one-third saying the system needs to be rebuilt completely. The journal <em>Health Affairs</em> published the findings today as a Web Exclusive.<br><br>More than half (54%) of U.S. chronically ill patients did not get recommended care, fill prescriptions, or see a doctor when sick because of the cost, compared with 7 percent to 36 percent in the seven other countries. About one-third of U.S. patients--again, the highest proportion--experienced medical, medication, or lab/diagnostic test errors. One-third encountered poorly coordinated care, including duplication of tests or medical records that were unavailable at the time of an appointment. And, reflecting the pervasiveness of high cost-sharing and coverage gaps, 41 percent of U.S. patients spent more than $1,000 in the past year on out-of-pocket medical costs, compared with 4 percent in the U.K. and 8 percent in the Netherlands.<br><br>"The study highlights major problems in our broken health care system and the need to make major changes," said Commonwealth Fund Senior Vice President Cathy Schoen, lead author of the <em>Health Affairs</em> article. "Patients are telling us about inefficient, unsafe, and often wasteful care. Moreover, a lack of access as well as poor coordination of care is putting chronically ill patients at even higher health risk."</p>