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Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care

Abstract

Issue: The United States health care system spends far more than other high-income countries, yet has previously documented gaps in the quality of care.
Goal: This report compares health care system performance in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States.
Methods: Seventy-two indicators were selected in five domains: Care Process, Access, Administrative Efficiency, Equity, and Health Care Outcomes. Data sources included Commonwealth Fund international surveys of patients and physicians and selected measures from OECD, WHO, and the European Observatory on Health Systems and Policies. We calculated performance scores for each domain, as well as an overall score for each country.
Key findings: The U.S. ranked last on performance overall, and ranked last or near last on the Access, Administrative Efficiency, Equity, and Health Care Outcomes domains. The top-ranked countries overall were the U.K., Australia, and the Netherlands. Based on a broad range of indicators, the U.S. health system is an outlier, spending far more but falling short of the performance achieved by other high-income countries. The results suggest the U.S. health care system should look at other countries’ approaches if it wants to achieve an affordable high-performing health care system that serves all Americans.

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Publication Details

Publication Date: July 14, 2017
Contact: Eric C. Schneider, M.D., Senior Vice President for Policy and Research, The Commonwealth Fund
Email: es@cmwf.org
Citation:

E. C. Schneider, D. O. Sarnak, D. Squires, A. Shah, and M. M. Doty, Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care, The Commonwealth Fund, July 2017.

Experts

Eric C. Schneider, M.D.
Senior Vice President for Policy and Research, The Commonwealth Fund
Former Senior Research Associate, International Program in Health Policy and Practice Innovations, The Commonwealth Fund
Former Senior Researcher to the President, The Commonwealth Fund
Arnav Shah
Research Associate, Research and Policy, The Commonwealth Fund
Michelle M. Doty
Vice President, Survey Research and Evaluation, The Commonwealth Fund