Canada lags behind other developed countries, except the United States

 Canada lags in patient care
Survey of 6,000 doctors ranks Canada 6th out of 7
Nov. 3, 2006. 10:37 AM
BETH GORHAM
CANADIAN PRESS

WASHINGTON Canada lags far behind other developed countries, except the United
States, in an international study of effective primary health care for patients
released yesterday by the Commonwealth Fund.

The poll of more than 6,000 doctors in seven countries gave Canada poor marks on
aspects of patient care, including wait times for tests, use of electronic
medical records, doctor availability after hours, multi-discipline teams to
treat chronic illness and financial incentives for improving quality of care.

The survey suggests Canada has a long way to go to match the other five:
Germany, the United Kingdom, the Netherlands, New Zealand and Australia.

For instance, only 47 per cent of Canadian doctors have arrangements for
after-hours care so people can avoid going to an emergency room, compared with
95 per cent in the Netherlands. Only the U.S. is lower than Canada at 40 per
cent.

Canada had the lowest rate of doctors giving plans for home care to patients
with chronic diseases. They also wait longest for full hospital discharge
reports or do not get them at all.

Among other findings:

#
51 per cent report patients face long waits for diagnostic tests while 6 per
cent do so in Australia.

#
32 per cent routinely work with multi-disciplinary teams and non-physicians to
treat chronic illnesses versus 81 per cent in the United Kingdom.

#
27 per cent set formal targets for clinical performance, but 70 per cent do so
in Germany and the U.K.

#
23 per cent use electronic medical records; 98 per cent do so in the
Netherlands.

There's a growing consensus about the need for team-based, comprehensive care,
said Frank Fedyk, Canada's acting assistant deputy health minister.


U.S. Lags in Several Areas of Health Care, Study Finds

By Christopher Lee
Washington Post Staff Writer
Friday, November 3, 2006; A14

Americans have a harder time than residents of several other countries getting
after-hours appointments with a nurse or primary care physician without going to
an emergency room, a study released yesterday found.

Forty percent of U.S. primary care doctors said they had arrangements for
after-hours care, according to the survey of more than 6,000 physicians in seven
countries. That compared with 95 percent in the Netherlands, 90 percent in New
Zealand, 87 percent in the United Kingdom, 76 percent in Germany and 47 percent
in Canada.

The study, published online by the journal Health Affairs, also found that the
United States trails other countries in adopting electronic medical records and
computerized systems to remind patients about follow-up care, prompt physicians
to give patients test results and warn of potentially harmful drug interactions.
It found that primary care doctors in America were less likely to have financial
incentives to improve the quality of the care they provide.

"Although the U.S. pays more for health care than any other country, we are
under-investing in our primary care system," Karen Davis, president of the
Commonwealth Fund, the foundation that sponsored the survey, said in a
statement. "Other countries have made high-quality primary care a priority by
putting into place the financial and technical systems that support access to,
and delivery of, such care."

The study is the latest of many to document that the United States lags on some
measures of health and care despite spending more on medical care than any other
nation. Annual U.S. medical spending was $5,635 per person in 2003. The next
highest among the seven countries surveyed was $3,003 in Canada; the Netherlands
spent the least, $1,886 per person. In that vein, U.S. primary care doctors were
the most likely to say their patients often had difficulty paying for
medications or other care, the survey found.

Advocates say greater use of electronic records would improve patient care,
reduce errors, curb unnecessary tests and cut paperwork. About 28 percent of
U.S. primary care doctors said they use such records, compared with 98 percent
in the Netherlands, 92 percent in New Zealand, 89 percent in the United Kingdom,
79 percent in Australia and 42 percent in Germany. Only Canada ranked lower, at
23 percent.

Twenty-three percent of U.S. physicians said they had a computerized system to
alert them to a potential problem with a drug dose or interaction. In all other
countries except Canada (10 percent), more physicians reported using such
systems. The Netherlands was highest at 93 percent. The United States and Canada
also ranked lower than the others in use of computerized systems to remind
patients to get follow-up care or to remind doctors to give patients test
results.

Only 30 percent of U.S. doctors said they have financial incentives to improve
the quality of the care they provide, even as more policymakers say physicians
should be rewarded for the quality, rather than just the volume, of services.
The United Kingdom ranked highest, with 95 percent of doctors saying they
received such incentives. The United States was last, the survey found.

One area where "pay for performance" is making significant inroads in the United
States is in HMOs, according to a separate study published yesterday in the New
England Journal of Medicine.

The study, by Harvard School of Public Health researchers, found that 52 percent
of managed-care plans, accounting for more than 81 percent of people enrolled in
HMOs, base payments to their providers in part on quality. The authors said the
study provided the first national estimate of the use of pay for performance by
the nation's health plans.

  Don't feel too bad, Canada.  Your health care may only be a little
better than in the States, but it's also much, much cheaper.

 

in the States, but

And there is no possibility of being bankrupted by a serious medical problem.

 nospam@nospam.com wrote


On a rather bogus basis tho.


Much of that is pretty wanky.


We'll see...


What is wrong with the emergency room for that stuff ?

It usually makes most sense even during normal hours
and many doctors use those for real emergencys.

There arent too many except the incompetant that need any
after hours 'care' that arent real emergencys and it makes
sense for those incompetants to use emergency depts.


Looks like a stupid way to do things. Makes a lot more sense to
cover that stuff with emergency depts and 24 hour operations etc.


What matters is how many of those chronic diseases are a mobility problem.


Too unspecific. What matters is how long the waits
actually are and whether the wait matters clinically.


That doesnt necessarily matter either. It may well be that much of that
actually involves nurses so its no big deal that Canada doesnt do it as much.


Thats a complete wank anyway.


Non electronic medical records work fine.


Wota fucking wanker.


So ?  It makes a lot of sense to cover real emergencys
with emergency rooms and ambulances etc.


So what ?


Because it isnt the bureaucratic system seen elsewhere.


Yep, FAR too much of what gets spent gets pissed against the wall
in the paper warfare system that the stupid insurance system involves.


Meaningless waffle.


See above.


Yep, because of the stupid US system for that,
and the grossly higher prescription rate as well.


Easy to claim. Harder to substantiate that claim.


Again, easy to claim, hell of a lot harder to actually do anything useful.


Because the US system doesnt have the same level of bureaucracy, stupid.


And lets not forget that the US started that stuff.


Again, easy to waffle.