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Sue Ducat
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In Eleven-Country Survey Of Older Adults, Americans Are Sickest But Have Quickest Access To Specialists

Bethesda, MD--A new survey of the health and care experiences of older adults in eleven different countries, released today as a Web First by Health Affairs, found that Americans were sicker than their counterparts abroad, with 68 percent of respondents living with two or more chronic conditions and 53 percent taking four or more medications. Also, Americans were most likely to report cost-related expenses for care (19 percent of respondents) than residents in any of the other countries surveyed. On the other hand, the United States compared favorably in some aspects: For example, 83 percent of US respondents had a treatment plan they could carry out in their daily life, one of the highest rates across the surveyed countries.

International Survey Of Older Adults Finds Shortcomings In Access, Coordination, And Patient-Centered Care


By Robin Osborn, Donald Moulds, David Squires, Michelle M. Doty, and Chloe Anderson


All the authors are affiliated with The Commonwealth Fund in New York.


This study, which was supported by The Commonwealth Fund, will also appear in the December issue of Health Affairs.


A few other key findings:

  • Only 57 percent of American respondents could get same-day or next-day medical appointments when sick. This was lower than many countries (83 percent in France and New Zealand and 81 percent in Germany) but higher than Canada (45 percent).

  • Regarding getting specialty care appointments, the reverse was found: Eighty-six percent of Americans reported waiting less than four weeks, better than any other country except Switzerland (82 percent).

  • In the area of care coordination, Americans were the most likely (23 percent) to report that test results or records were not available at doctors' appointments or duplicate tests had been ordered. However, in assessing post-hospitalization care, Americans were among the least likely (28 percent) to have experienced gaps in discharge planning.

The study surveyed 15,617 adults ages sixty-five and older in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. This is the seventeenth in a series of international survey analyses from this group of authors. However, past surveys have assessed the health and health care of general populations, where, according to the authors, "the United States has been the outlier...for its high numbers of uninsured people and the absence of national standards for essential benefits or financial protection." This survey of an older population, with near-universal coverage of Americans by Medicare or some other health insurance, allowed the authors "to compare more directly the performance of the US health care delivery system with...other industrialized nations."


About Health Affairs

Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically at The full text of each Health Affairs Web First paper is available free of charge to all website visitors for a one-week period following posting, after which it switches to pay-per-view for nonsubscribers. Web First papers are supported in part by a grant from The Commonwealth Fund. You can also find the journal on Facebook and Twitter. Read daily perspectives on Health Affairs Blog. Download our podcasts, including monthly Narrative Matters essays, on iTunes. Tap into Health Affairs content with the new iPad app.