The U.S. health care system ranked last, compared with several other industrialized nations, on measures of quality, efficiency, patient safety, access to care, and equity, according to a new report by the Commonwealth Fund.
One of the main reasons for the low ranking is the lack of universal health insurance, according to the report. Although the United States spends the most overall on health care, it fails to provide access for low-income individuals. Furthermore, unlike their counterparts in other industrialized countries, U.S. patients usually don't have a medical home.
The United States ranked first, however, on areas such as preventive care and wait time for specialist care.
One measure on which the United States ranked a “clear last” is equity, according to the study. Compared with their counterparts in Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom, low-income patients in the United States are less likely to visit a physician when they're sick, see a dentist, or receive recommended tests, treatments, or follow-up care.
“When a country fails to meet the needs of the most vulnerable, it also fails to meet the needs of the average citizen,” according to the report. The United States “should devote far greater attention to seeing a health system that works well for all Americans.”
The report is the result of a compilation of mortality data from several countries and surveys of about 21,000 adults and 6,700 physicians regarding their experiences with care and their ratings of various dimensions of care. The study authors said that despite the differences among the countries, measures such as access to care and emergency department visits are universal.