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New Cross-National Comparisons of Health Systems



U.S. Scores Well on Effectiveness, Poorly on Many Other Measures in Patient Surveys, Has Greatest Inequity for Lower-Income Patients

To hear a teleconference about the release of these reports held Tuesday, April 4, listen to the online recording.

Even though the U.S. spends more than twice as much per capita on health care than other countries, the U.S. health care system ranks lower than several other countries in patients' perspectives on the safety, efficiency, equity, and patient-centeredness of health care, according to two new Commonwealth Fund analyses. The U.S. also stands out for having wide and pervasive health care disparities based on income, though the country scored well on effectiveness of care, especially preventive care.

The findings are from two new Commonwealth Fund reports analyzing cross-national surveys of adults' health care experiences in Australia, Canada, Germany, New Zealand, the U.K., and the U.S.

One report, Mirror, Mirror, on the Wall: An Update on the Quality of American Health Care Through the Patient's Lens, by Commonwealth Fund President Karen Davis, Ph.D., and colleagues, focuses on overall U.S. performance, ranking the national average based on patient reports in two cross-national surveys.


The companion report, The U.S. Health Care Divide: Disparities in Primary Care Experiences by Income—Findings from the Commonwealth Fund 2004 International Health Policy Survey by Phuong Huynh, Ph.D., associate director of the Fund's International Health Policy program, Cathy Schoen, the Fund's senior vice president for research and evaluation, and colleagues examines patients' experiences with primary care by income.



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