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Comparing Nations on Timeliness and Coordination of Health Care

Findings from the 2021 Commonwealth Fund International Health Policy Survey of Older Adults

Elderly man and daughter wait in line with walker

Jack Orre and his daughter Linda Davis wait in line at a COVID-19 vaccine clinic held for seniors by the Los Angeles County Department of Public Health on Wednesday, March 31, 2021, in Lakewood, Calif. U.S. seniors are more likely than their counterparts in other wealthy countries to experience economic hardship as a result of the pandemic, with Latinx/Hispanic and Black seniors most affected. Photo: Irfan Khan/Los Angeles Times via Getty Images

Jack Orre and his daughter Linda Davis wait in line at a COVID-19 vaccine clinic held for seniors by the Los Angeles County Department of Public Health on Wednesday, March 31, 2021, in Lakewood, Calif. U.S. seniors are more likely than their counterparts in other wealthy countries to experience economic hardship as a result of the pandemic, with Latinx/Hispanic and Black seniors most affected. Photo: Irfan Khan/Los Angeles Times via Getty Images

Aging populations present major challenges to health care systems around the world. The 2021 Commonwealth Fund International Health Policy Survey, conducted among adults age 65 and older between March and June 2021, provides insights about how well U.S. seniors fare relative to older adults in 10 other high-income countries. (See “About This Survey” below.)

The findings present a mixed picture of U.S. health system performance as the COVID-19 pandemic continues:

  • U.S. seniors are more likely than their counterparts in other wealthy countries to experience economic hardship as a result of the pandemic, with Latino/Hispanic and Black seniors most affected. Nearly four in 10 older Latino/Hispanic adults and one in three older Black adults said they used up their savings or lost a job or source of income because of COVID-19, compared to 14 percent of older white adults.
  • Despite the near-universal coverage Medicare provides, U.S. older adults have comparatively high out-of-pocket health expenses and are much more likely to forgo care because of cost than are their counterparts in the other survey countries.

Overview of Survey Findings on Timeliness and Coordination of Care

The charts that follow present the international survey’s findings on timeliness and coordination of care: how quickly and easily older adults are able to get care when they need it, including through video or telephone appointments; and how well ongoing care is coordinated for patients with multiple chronic conditions.

Responses show that many older adults, both in the U.S. and other countries, experience problems getting timely health care, including waits of six days or more to see a doctor when sick, difficulty in getting after-hours care without visiting an emergency department, and delays in hearing back from their regular doctor on the same day.

The U.S., however, does comparatively well on coordination of patient care, a set of findings consistent with other studies and with previous Commonwealth Fund surveys of older adults. Older adults in the U.S. were the least likely of those surveyed to experience gaps in hospital discharge planning. Among U.S. respondents with chronic conditions, a majority reported having a treatment plan and being in contact with care providers between office visits.

Doty_timeliness_coordination_2021_intl_survey_older_adults_exhibit_12
Doty_timeliness_coordination_2021_intl_survey_older_adults_exhibit_13

About this Survey

  • Twenty-third in the Commonwealth Fund’s series of international health policy surveys, and the eighth survey focusing on older and/or sicker adults
  • Survey research firm SSRS interviewed nationally representative samples of 18,477 adults age 65 and older across 11 countries: Australia (501), Canada (4,332), France (1,751), Germany (1,163), Netherlands (630), New Zealand (500), Norway (500), Sweden (3,018), Switzerland (2,597), United Kingdom (1,876), United States (1,609)
  • Survey completed online or through computer-assisted landline or mobile phone interviews between March 1 and June 14, 2021
  • Learn more about the survey here

Acknowledgments

The authors thank SSRS and the following cofunders:

  • Canada: Health Quality Ontario; Canadian Institute for Health Information; Commissaire à la santé et au bien-être du Quebec; Ministère de la Santé et des Services sociaux
  • France: La Haute Autorité de Santé; Caisse Nationale d'Assurance Maladie des Travailleurs Salariés; Directorate for Research, Evaluation, Studies, and Statistics of the French Ministry of Health
  • Germany: German Ministry of Health and BQS Institute for Quality and Patient Safety
  • Netherlands: Dutch Ministry of Health, Welfare and Sport and Radboud University Medical Center
  • Sweden: Swedish Agency for Health and Care Services Analysis (Vård- och omsorgsanalys)
  • Switzerland: Swiss Federal Office of Public Health
  • United Kingdom: The Health Foundation

Publication Details

Date

Contact

Michelle M. Doty, Vice President, Organizational Effectiveness, Survey Research and Evaluation, The Commonwealth Fund

[email protected]

Citation

Michelle M. Doty et al., Comparing Nations on Timeliness and Coordination of Health Care: Findings from the 2021 Commonwealth Fund International Health Policy Survey of Older Adults (Commonwealth Fund, Oct. 2021). https://doi.org/10.26099/sdxp-wq12