Member   Join Date: Oct 2004
Posts: 520  

Patients Report Dissatisfaction With Care

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Hey, at the other dental frat club, the messenger would be harrassed,
tortured, slowly put to death, dissembowelled after death, and then
permanently bannished for posting this.... but that won't happen here.
Flap does not do those things.  

Anyway, the ADA posted this...not me. Since this was posted on the ADA
site, I ask do you think these sentiments include those toward dental
services as well? ...Any Comments?

Patients Report Dissatisfaction With Care
Survey of five industrial nations finds Americans most unhappy
By Amanda Gardner
HealthDay Reporter

THURSDAY, Oct. 28 (HealthDayNews) -- A survey of patients in five of
the world's top industrialized nations finds wide variations in
primary care quality and access -- and considerable dissatisfaction
with care, especially in the United States.

"The survey indicates shortfalls in accessibility, coordination,
safety, and patient-centered care," said Cathy Schoen, lead author of
the report and a vice president for health policy, research, and
evaluation at The Commonwealth Fund.

But identifying the problem is often the first step toward solving it,
others pointed out.

"This is a wonderful tool and gift that's been given to us," said Dr.
Andrew Bindman, associate professor of medicine, epidemiology, and
biostatistics at the University of California, San Francisco.

Both Schoen and Bindman spoke Thursday at a news briefing in
Washington, D.C., to unveil the survey results; the session was
attended by health ministers from seven countries. The findings also
appear in the Oct. 28 online edition of the journal Health Affairs.

Primary care can be considered a bellwether for how well the overall
health-care system is doing. "Primary care is instrumental to country
performance, and helps countries integrate complex or multiple sites
of care," Schoen said.

The report, titled Primary Care and Health System Performance: Adults'
Experiences in Five Countries, is based on the 2004 Commonwealth Fund
International Health Policy Survey, which polled 1,400 adults in each
of the five nations -- Australia, Canada, New Zealand, the United
Kingdom, and the United States -- between March and May 2004. The
report is the seventh in a series of annual international surveys.

Respondents in the United States were most negative in their overall
views of primary care, while respondents in the United Kingdom were
the least negative, echoing previous findings. One-third of U.S.
adults called for rebuilding the health-care system. Views in New
Zealand and Canada have grown increasingly positive over the past six
years, with fewer calls to rebuild. The mood in Australia, meanwhile,
has fluctuated. Still, the majority in each of the nations favored
major reform, with only a minority indicating they were "very
confident" they would get high-quality and safe medical care when they
needed it.

"In no country is the majority of patients satisfied," Schoen said.
"Most indicate a need for substantial reform."

Patients in the United States and Canada reported the most difficulty
getting same-day appointments when they were sick, and reported waits
of six days or more. Not surprisingly, this lack of access translated
into higher use of emergency rooms for non-emergencies in both
countries.

While about half of patients rated their emergency-room experiences as
excellent or very good, sizable proportions in all five countries said
they had waits of two or more hours before being treated.

Perhaps more disturbing, up to 15 percent of patients in each country
reported getting incorrect test results or delays in being notified of
abnormal results. The problem was most acute in the United States.

"This is a missed opportunity for engaging patients in their own
care," said Robin Osborn, a report co-author and vice president and
director of the Commonwealth Fund's International Program in Health
Policy and Practice. "This finding points to other system failures
that may have serious consequences in terms of coordination of care."

The United States had the best rates of preventive care, such as Pap
tests and mammograms, but reported the most out-of-pocket medical
costs.

One-fourth of U.S. respondents said they had paid more than $1,000 in
out-of-pocket medical costs in the past year, compared to 4 percent to
14 percent in the other countries. Perhaps as a result of this, U.S.
patients were also more likely to say they had gone without needed
care because of cost issues, with two out of five reporting access
problems related to cost.

"Cost affects access, and we see quite stark country differences that
reflect insurance systems and the comprehensiveness of benefit
packages," Schoen said. "The U.S. stands out as the most exposed to
medical bills when seeking medical care, and the U.K. stands out as
the most protected." Britons are covered under a nationwide health
system run by the government.

Lower-income adults in all countries were more likely to forgo medical
care, but the rates were again highest in the United States, with 57
percent saying they went without care vs. 12 percent in the United
Kingdom.

The report also tracked communication and relationship issues between
doctors and patients. Respondents in all nations said the doctor
spends enough time, although Australia and New Zealand had the highest
ratings in patient-centered care. The United States scored last on
this count.

While the report highlighted deficiencies, it also pointed to
opportunities, the authors said. "These shortfalls are amenable to
policy action, and we have a great opportunity," Osborn said.

More information

To see the full report, click on Health Affairs.

SOURCES: Oct. 28, 2004, news conference with Cathy Schoen, vice
president for health policy, research, and evaluation, The
Commonwealth Fund; Robin Osborn, vice president and director,
International Program in Health Policy and Practice, The Commonwealth
Fund; Andrew Bindman, M.D., associate professor of medicine,
epidemiology and biostatistics, University of California, San
Francisco; Oct. 28, 2004 Health Affairs online

Last Updated: Oct-28-2004 Copyright © 2004 ScoutNews, LLC. All rights
reserved.

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Last edited by Sue : Today at 01:18 PM.