May 12, 2006 — A new study says that the United States is up to a dozen years behind other developed nations in adopting health information technology systems. Yet the nation spends two-and-a-half times more per capita on health care than the median country among the 30 nations belonging to the Organization for Economic Cooperation and Development (OECD), the study notes.
The authors stopped short of saying underuse of health IT explains the apparently bloated levels of health spending in the United States. But to the extent the technology saves money, the lack of a national information technology network "could exacerbate the position of the United States relative to countries that are [health IT] leaders," the study said.
Led by Johns Hopkins health policy professor Gerard F. Anderson, the study compares spending patterns for various aspects of health care in addition to health IT. "The higher level of U.S. health spending does not necessarily provide more resources or health care use," it says. "For example, in 2003, the United States had fewer physicians, nurses, and hospital beds per capita than the median OECD country had, and one of the lowest numbers of acute care bed days per capita."
And while the United States adopts some forms of technology more quickly than other industrialized countries, its overall rate of adoption is ultimately similar. Thus the United States had the same number of CT scanners (also known as CAT scans) per million people in 2003 as the median OECD country, and nine other countries had more magnetic resonance imaging scanners, or MRI machines, per capita than the U.S. did, the study says.
Another finding that is perhaps surprising given the nation's reputation for use of sophisticated care: U.S. doctors performed the highest number of kidney transplants per 100,000 people, but were tied for fourth in heart transplants and were third in the number of liver transplants.
The most compelling reason for higher spending in the U.S. was not technology or costly procedures but prices, according to the study. In 2003, the United States "continued to pay much higher prices in three key health care components: physician visits, hospital stays, and pharmaceuticals."
U.S. doctors have been adopting some of the building blocks of health IT, such as computers, personal digital assistants, Internet access, and Web sites, at rates comparable to counterparts abroad. But the United States trails in developing a national program to foster the use of electronic health records, the study says.
Government outlays for health IT totaled $125 million in the United States in 2005, compared with $1 billion in Canada, $1.8 billion in Germany, and $11.5 billion in the United Kingdom. On a per capita basis those outlays computed to 43 cents in the United States compared with $193 in the United Kingdom.
"Many countries have subsidized the application of [health IT] with public funds, on the condition that those systems can interconnect," the study authors said. "The United States has begun to do so in recent years as well; although so far on a much more modest scale."
The United States could shorten the time it takes to implement health IT "if it can learn from these countries' experiences," the study suggests. It cautions, however, that "in all countries, we found no evidence that the savings from these initiatives have been rigorously evaluated."