Transcript Full Chartpack - The Commonwealth Fund

THE
COMMONWEALTH
FUND
The Commonwealth Fund
2010 International Health Policy Survey
in Eleven Countries
The Commonwealth Fund
November 2010
2
2010 International Health Policy Survey
• Telephone survey March to June 2010 of adults ages 18 and older
in Australia, Canada, France, Germany, the Netherlands, New
Zealand, Norway, Sweden, Switzerland, the United Kingdom, and
the United States.
• Final samples: 3,552 Australia, 3,302 Canada, 1,402 France, 1,005
Germany, 1,001 Netherlands, 1,000 New Zealand, 1,058 Norway,
2,100 Sweden, 1,306 Switzerland, 1,511 United Kingdom, and
2,501 United States.
• Conducted by Harris Interactive subcontractors, and Dutch
Scientific Institute for Quality of Healthcare, Haute Authorité de
Santé (HAS), Swedish Ministry of Health, Swiss Federal Office of
Public Health, and Norwegian Knowledge for the Health Services.
• Examined differences between above- and below-average (median)
income respondents, controlling for age and health status
THE
COMMONWEALTH
FUND
3
2010 International Health Policy Survey
•
A selection of findings from the 2010 Commonwealth Fund
International Health Policy Survey were originally published in:
C. Schoen, R. Osborn, D. Squires, M. M. Doty, R. Pierson, and
S. Applebaum, "How Health Insurance Design Affects Access to
Care and Costs, by Income, in Eleven Countries," Health Affairs
Web First, Nov. 18, 2010.
•
This chartpack presents data beyond what was included in the
article.
THE
COMMONWEALTH
FUND
4
International Comparison of Spending on Health, 1980–2008
Total expenditures on health
as percent of GDP
Average spending on health
per capita ($US PPP)
16
7000
6000
5000
4000
United States
Norway
Switzerland
Canada
Netherlands
Germany
France
Denmark
Australia
Sweden
United Kingdom
New Zealand
14
12
10
8
2000
4
1000
2
0
0
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
3000
6
United States
France
Switzerland
Germany
Canada
Netherlands
New Zealand
Denmark
Sweden
United Kingdom
Norway
Australia
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
8000
THE
COMMONWEALTH
FUND
Source: OECD Health Data 2010 (June 2010).
5
System Views and Confidence
THE
COMMONWEALTH
FUND
6
Overall Views of Health Care System, 2010
Percent
AUS
CAN
FR
GER
NETH
NZ
NOR
SWE
SWIZ
UK
US
Only minor
changes
needed
24
38
42
38
51
37
40
44
46
62 29
Fundamental
changes
needed
55
51
47
48
41
51
46
45
44
34 41
Rebuild
completely
20
10
11
14
7
11
12
8
8
3
27
THE
COMMONWEALTH
FUND
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
7
Confident Will Receive Most-Effective Treatment if Sick
Percent responded, if they became seriously ill, confident/very confident they
would get most-effective treatment, including drugs and diagnostic tests
100
85
76
76
82
88
89
84
75
70
67
NOR
SWE
92
70
50
25
0
AUS
CAN
FR
GER NETH
NZ
SWIZ
UK
US
THE
COMMONWEALTH
FUND
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
8
Confident Will Be Able to Afford Needed Care
Percent responded, if they became seriously ill, confident/very confident they
would be able to afford the care they needed
100
90
81
75
64
68
73
70
75
78
69
70
58
50
25
0
AUS
CAN
FR
GER NETH
NZ
NOR
SWE
SWIZ
UK
US
THE
COMMONWEALTH
FUND
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
9
Affordability and Cost-Related Access Barriers
THE
COMMONWEALTH
FUND
10
Out-of-Pocket Medical Costs
in the Past Year, in U.S. Dollars
$200 or less
Percent
$1,000 or more
100
76
75
61
51
50
47
35
50
41 39
33
25
21
20
25
35
31
16
12
4
9
8
7
2
1
US
UK
SW
IZ
SW
E
NO
R
NZ
H
NE
T
GE
R
FR
CA
N
AU
S
US
UK
SW
IZ
SW
E
NO
R
NZ
H
NE
T
GE
R
FR
CA
N
AU
S
0
THE
COMMONWEALTH
FUND
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
11
Cost-Related Access Problems
in the Past Year
Percent
AUS
CAN
FR
GER
NETH
NZ
NOR
SWE
SWIZ
UK
US
Did not fill
prescription or
skipped doses
12
10
7
6
3
7
6
7
4
2
21
Had a medical
problem but
did not visit
doctor
13
4
6
16
2
9
6
5
6
2
22
Skipped test,
treatment, or
follow-up
14
5
6
10
3
8
5
4
4
3
22
Yes to at least
one of the
above
22
15
13
25
6
14 11
10
10
5
33
THE
COMMONWEALTH
FUND
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
12
Serious Problems Paying or Unable to Pay
Medical Bills in the Past Year
Percent
40
30
20
20
10
8
6
9
3
4
6
5
5
6
NOR
SWE
SWIZ
2
0
AUS
CAN
FR
GER NETH
NZ
UK
US
THE
COMMONWEALTH
FUND
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
13
Access to Needed Care and Waiting Times
THE
COMMONWEALTH
FUND
14
Access to Doctor or Nurse When Sick or Needed Care
Same- or next-day
appointment
Percent*
Waited six days
or more
93
100
75 65
62
66
72
78
70
57
45
50
57
45
33
25
28 25
19
17 16
14
5
5
2
8
* Base: Answered question.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
US
UK
SW
IZ
SW
E
NO
R
NZ
H
NE
T
GE
R
FR
CA
N
AU
S
US
UK
SW
IZ
SW
E
NO
R
NZ
H
NE
T
GE
R
FR
CA
N
AU
S
0
THE
COMMONWEALTH
FUND
Worried About a Medical Problem That Took a Long Time
to Be Diagnosed in Past Year
15
Percent
40
30
23
21
20
18
16
14
15
17
14
11
10
9
8
SWIZ
UK
0
AUS
CAN
FR
GER NETH
NZ
NOR
SWE
US
THE
COMMONWEALTH
FUND
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
16
Difficulty Getting After-Hours Care
Without Going to the Emergency Room
Percent reported very/somewhat difficult getting care on nights,
weekends, or holidays without going to ER*
100
75
59
65
63
68
63
57
50
33
38
45
43
38
25
0
AUS
CAN
FR
GER NETH
NZ
NOR
SWE
* Base: Needed care and answered question.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
SWIZ
UK
US
THE
COMMONWEALTH
FUND
17
Emergency Room Use in Past Two Years
Any ER use
Percent
Used ER for condition treatable
by regular doctor, if available
75
50
44
37
35
33
27
22
25
26
29
26
22
25
16
10
5
10 8
5
12
7
15
9
7
US
UK
SW
IZ
SW
E
NO
R
NZ
H
NE
T
GE
R
FR
CA
N
AU
S
US
UK
SW
IZ
SW
E
NO
R
NZ
H
NE
T
GE
R
FR
CA
N
AU
S
0
THE
COMMONWEALTH
FUND
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
18
Wait Time in Emergency Room Before Being Treated
Less than 30 minutes
Four hours or more
Percent
75
52
46
50
44
34 33
33
33
29
34
31
26
20
25
20
17
16
13
12 11
4
6
3
4
Base: Used ER in past two years.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
US
UK
SW
E
SW
IZ
R
NO
NZ
H
NE
T
G
ER
FR
N
CA
S
AU
US
UK
R
SW
E
SW
IZ
NO
NZ
H
NE
T
G
ER
FR
N
CA
AU
S
0
THE
COMMONWEALTH
FUND
19
Wait Time for Specialist Appointment
Less than 1 month
Percent
Two months or more
100
83
82
72
70
75
80
61
54
53
50
50
41
45
41
28
34 31
28
25
16
22
19
7
9
5
Base: Needed to see a specialist in past two years.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
US
UK
SW
E
SW
IZ
R
NO
NZ
H
NE
T
G
ER
FR
N
CA
S
AU
US
UK
R
SW
E
SW
IZ
NO
NZ
G
ER
NE
TH
FR
N
CA
AU
S
0
THE
COMMONWEALTH
FUND
20
Wait Time for Elective Surgery
Less than 1 month
Percent
Four months or more
100
78
68
75
59
53
55
54
46
50
59
44
35
34
25
21 22
18
25
7
5
0
8
21
7
7
Base: Needed elective surgery in past two years.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
US
UK
SW
E
SW
IZ
R
NO
NZ
H
NE
T
G
ER
FR
N
CA
S
AU
US
UK
R
SW
E
SW
IZ
NO
NZ
G
ER
NE
TH
FR
N
CA
AU
S
0
THE
COMMONWEALTH
FUND
21
Primary Care and Patient-Centered Care
THE
COMMONWEALTH
FUND
22
Easy to Contact Doctor by Phone
During Regular Hours
Percent reporting somewhat/very easy
100
88
76
75
82
78
90
84
83
73
62
79
61
50
25
0
AUS
CAN
FR
GER NETH
NZ
NOR
SWE
Base: Has regular doctor/place of care and tried contacting.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
SWIZ
UK
US
THE
COMMONWEALTH
FUND
23
Online Access at Regular Place of Care
Percent
AUS
CAN
FR
GER
NETH
NZ
NOR
SWE
SWIZ
UK
US
Has e-mailed
medical question
to regular doctor
or place of care
in past two years
2
4
2
7
2
4
4
6
3
9
6
Can make an
appointment via
e-mail or Web
site at regular
place of care
7
6
9
60
10
9
23
13
13
25 15
Base: Has regular doctor/place of care.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
THE
COMMONWEALTH
FUND
24
Nurse Regularly Involved in Care
Percent reported a nurse or other nonphysician clinician
is regularly involved in care*
100
75
57
50
56
42
27
25
33
23
18
51
37
25
16
0
AUS
CAN
FR
GER NETH
NZ
NOR
SWE
SWIZ
UK
US
Base: Has regular doctor/place of care.
* For example, discusses test results, treatment plans or advises you on your health.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
THE
COMMONWEALTH
FUND
25
Doctor–Patient Communication
Percent reports
regular doctor
always/often
AUS
CAN
FR
GER
NETH
Gives opportunity
to ask questions
about
recommended
treatment
88
85
83
91
Explains things in
a way that is easy
to understand
91
89
89
Involves you as
much as you want
in care decisions
86
83
Spends enough
time with you
85
All of the above
69
NZ
NOR
SWE
SWIZ
87
92 77
65
92
91 86
94
93
92 86
74
94
89 89
82
84
81
92 80
62
85
90 86
80
85
91
89
90 76
67
90
88 82
60
59
63
75
79 62
47
72
59 63
Base: Has regular doctor/place of care.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
UK
US
THE
COMMONWEALTH
FUND
26
Regular Doctor Knows Important Information
About Medical History
Percent reporting doctor often/always knows important information
about medical history
100
87
92
84
84
88
93
89
89
SWIZ
UK
85
75
75
57
50
25
0
AUS
CAN
FR
GER NETH
NZ
NOR
SWE
Base: Has regular doctor/place of care.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
US
THE
COMMONWEALTH
FUND
27
Quality of Care from Doctor
Percent rated care received in past 12 months from regular doctor
as very good/excellent
100
84
76
75
74
79
69
67
49
50
74
59
54
43
25
0
AUS
CAN
FR
GER NETH
NZ
NOR
SWE
Base: Has regular doctor/place of care.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
SWIZ
UK
US
THE
COMMONWEALTH
FUND
28
Coordination of Care
THE
COMMONWEALTH
FUND
29
Regular Doctor Coordinates Care Received
from Other Doctors and Places
Percent reporting doctor always/often coordinates or arranges care
100
75
66
68
69
63
55
51
68
69
UK
US
55
50
35
26
25
0
AUS
CAN
FR
GER NETH
NZ
NOR
SWE
Base: Has regular doctor/place of care.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
SWIZ
THE
COMMONWEALTH
FUND
30
Coordination Problems in the Past Two Years
Percent
AUS
CAN
FR
GER
NETH
NZ
NOR
SWE
SWIZ
UK
US
Test results/
records not
available at time
of appointment
11
11
7
8
8
9
10
9
7
9
15
Received
conflicting
information from
different health
professionals
20
20 16
17
15
18
24
18
16
10 23
Duplicate tests:
doctors ordered
test that had
already been
done
10
8
14
20
4
5
9
5
11
7
Yes to at least
one of the above
28
28 28
29
21
23
31
23
24
19 37
17
THE
COMMONWEALTH
FUND
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
31
Coordination Problems in the Past Two Years,
by Number of Chronic Conditions
Percent experienced any of three
coordination problems*
No chronic conditions
2 or more chronic conditions
50
42
42
38
26
31
29
25
28 29
23
19
29
26 27
25
23
19
32
17
32 31
19
13
0
AUS
CAN
FR
GER
NETH
NZ
NOR
SWE
* Test results/records not available at time of appointment, received conflicting information
from different health professionals, and/or doctors ordered test that had already been done.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
SWIZ
UK
US
THE
COMMONWEALTH
FUND
32
Gaps in Coordination of Specialist Care
Specialist did NOT have reason for
visit/tests from regular doctor
Regular doctor NOT up-to-date
about specialist care
Percent
40
33
30
30
26
26
22
22
17
20
13
11
12
11
10
15 14
23
17
16
16
22
20
16
15
10
Base: Saw specialist in past two years and has regular doctor/place of care.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
US
UK
SW
E
SW
IZ
R
NO
NZ
H
NE
T
G
ER
FR
N
CA
S
AU
US
UK
SW
E
SW
IZ
R
NO
NZ
H
NE
T
G
ER
FR
N
CA
AU
S
0
THE
COMMONWEALTH
FUND
33
Gaps in Emergency Room Communication
with Regular Doctor
Percent for whom regular doctor/place did NOT seem informed or
up-to-date about care received in ER
60
44
45
30
28
33
32
30
23
31
22
27
27
UK
US
21
15
0
AUS
CAN
FR
GER NETH
NZ
NOR
SWE
Base: Has regular doctor/place of care, used ER in past two years and was treated.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
SWIZ
THE
COMMONWEALTH
FUND
34
Failure to Communicate Test Results
Percent for whom someone sometimes, rarely, or never
followed up to give results
60
42
45
30
26
30
21
24
21
12
15
9
5
7
11
0
AUS
CAN
FR
GER NETH
NZ
NOR
SWE
Base: Had blood tests, x-rays, or other tests in past two years.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
SWIZ
UK
US
THE
COMMONWEALTH
FUND
35
Perception of Inefficient or Wasteful Care
Percent felt time
wasted in past two
years because…
AUS
CAN
FR
GER
NETH
NZ
NOR
SWE
SWIZ
UK
US
Took long time to
schedule tests or
specialist
appointments
19
25
21
17
11
15
21
14
9
12
17
Kept waiting long
time to see doctor
for a scheduled
appointment
35
33
25
30
18
25
28
16
27
18
29
Care was poorly
organized or
poorly
coordinated
18
19
9
11
10
12
15
17
6
10
18
Yes to at least one
of the above
48
49
38
43
30
36
44
34
37
29
38
THE
COMMONWEALTH
FUND
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
36
Preventive Care
THE
COMMONWEALTH
FUND
37
Patient Receives Reminders for Due Preventive Care
Percent
100
75
59
50
45
56
56
49
47
39
42
37
28
22
25
0
AUS
CAN
FR
GER NETH
NZ
NOR
SWE
SWIZ
UK
US
THE
COMMONWEALTH
FUND
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
38
Health Promotion and Lifestyle Discussions
in Past Two Years
Percent reported
discussing at regular
place of care:*
AUS
CAN
FR
GER
NETH
A healthy diet
and healthy
eating
53
52
37
50
Exercise or
physical activity
54
56
56
Things in your
life that worry
you or cause
stress
43
44
Discussed any
of the above
67
71
NZ
NOR
SWE
SWIZ
UK
US
17
53 34
29
33
45 70
51
23
51 43
43
47
37 72
47
35
27
38 35
25
34
26 49
74
70
42
64 61
55
63
53 82
Base: Has regular doctor/place of care and visited in past two years.
* With doctor or other clinician.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
THE
COMMONWEALTH
FUND
39
Chronic Conditions and Self-Management
THE
COMMONWEALTH
FUND
40
Number of Chronic Conditions
Percent of
respondents with the
following number of
chronic conditions:
AUS
CAN
FR
GER
NETH
None
35
42
40
51
One
26
27
31
Two or more
40
31
29
NZ
NOR
SWE
SWIZ
UK
US
44
38 42
43
52
57 35
25
28
27 24
27
26
22 23
25
29
35 33
30
22
21 40
THE
COMMONWEALTH
FUND
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
Chronically Ill Patients Who Are Confident They Can
Manage Health Problems
41
Percent reported confident/very confident they can manage their health problems
100
95
91
93
93
97
87
96
91
91
93
UK
US
82
75
50
25
0
AUS
CAN
FR
GER NETH
NZ
NOR
SWE
Base: Adults with asthma, diabetes, heart disease, hypertension, and/or high cholesterol.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
SWIZ
THE
COMMONWEALTH
FUND
42
Blood Pressure in Normal Range Among Patients
with Heart Disease and/or Hypertension
Percent reported blood pressure in normal range last time checked
100
87
90
84
89
90
77
75
82
79
79
SWE
SWIZ
UK
84
66
50
25
0
AUS
CAN
FR
GER NETH
NZ
NOR
Base: Adults with heart disease and/or hypertension and had blood pressure checked in past year.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
US
THE
COMMONWEALTH
FUND
43
Diabetics with Glucose Level in Normal Range
Percent reported often/always keeping glucose level in normal range
100
79
75
74
74
67
80
78
75
76
UK
US
67
61
57
50
25
0
AUS
CAN
FR
GER NETH
NZ
NOR
SWE
Base: Adults with diabetes.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
SWIZ
THE
COMMONWEALTH
FUND
44
Prescription Drugs
THE
COMMONWEALTH
FUND
45
Confusion Over New Prescription
Percent reported being unsure what new prescription drug was for
or how to take it in past two years
40
30
20
10
6
8
10
9
8
8
4
10
6
5
SWE
SWIZ
7
0
AUS
CAN
FR
GER NETH
NZ
NOR
Base: Regularly takes at least one prescription drug.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
UK
US
THE
COMMONWEALTH
FUND
46
Experiences with Prescription Drugs in Past Two Years
Percent reported
someone from
regular place of care:
AUS
CAN
FR
GER
NETH
Did not review all
medications
including those
prescribed by
other doctors
21
31
42
45
Did not explain
the potential
side effects of a
medication
22
26
45
Did not give
written list of all
prescribed
medications
48
52
At least one of the
above problems
56
67
NZ
NOR
SWE
SWIZ
54
28 52
60
35
43 23
46
61
27 49
52
41
41 23
71
74
77
52 77
55
72
54 46
86
83
90
63 88
84
84
68 60
Base: Has regular doctor/place of care and regularly takes at least one prescription drug.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
UK
US
THE
COMMONWEALTH
FUND
47
Patient Safety
THE
COMMONWEALTH
FUND
48
Medical, Medication, or Lab Test Errors in Past Two Years
Percent reported:
AUS
CAN
FR
GER
NETH
NZ
NOR
SWE
SWIZ
UK
US
Wrong
medication
or dose
4
6
9
2
4
5
8
5
5
2
6
Medical mistake
in treatment
8
8
6
6
5
6
11
6
8
3
10
Incorrect
diagnostic/
lab test results*
2
4
3
2
3
2
3
2
3
3
5
Delays in
abnormal
test results*
6
10
3
5
4
6
9
8
2
6
9
14
17
14
10
11
12
21
13
13
8
18
Any medical,
medication, or
lab errors
* Base: Had blood test, x-rays, or other tests in past two years.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
THE
COMMONWEALTH
FUND
49
Medical, Medication, or Lab Test Errors
Occurred Outside Hospital
Percent reported error occurred outside hospital
100
82
86
84
79
80
86
88
79
79
86
68
75
50
25
0
AUS
CAN
FR
GER NETH
NZ
NOR
SWE
SWIZ
Base: Reported medical mistake, medication error, and/or lab test error or delay in past two years.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
UK
US
THE
COMMONWEALTH
FUND
50
Any Medical, Medication, or Lab Test Errors,
by Number of Doctors Seen
Percent
1 or 2 doctors
4 or more doctors
60
49
45
40
38
32
29
30
15
40
38
25
11
13
24
12
6
20
8
28
18
11
9
13
11
6
0
AUS
CAN
FR
GER NETH
NZ
NOR
SWE
SWIZ
Base: Reported medical mistake, medication error, and/or lab test error or delay in past two years.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
UK
US
THE
COMMONWEALTH
FUND
51
Insurance Complexity
THE
COMMONWEALTH
FUND
52
Problems with Health Insurance
Percent reported in
the past year:
AUS
CAN
FR
GER
NETH
NZ
NOR
SWE
SWIZ
UK
US
6
6
11
16
8
4
8
3
6
3
17
Health
insurance
denied payment
or did not pay
as much as
expected
11
12
18
11
15
4
2
2
10
2
25
Yes to either
14
15
23
23
20
6
9
4
13
5
31
Spent a lot of
time on
paperwork or
disputes over
medical bills
THE
COMMONWEALTH
FUND
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
53
Confidence, Cost and Access Experiences,
and Insurance Problems by Income
Slides 54 to 59: Adjusted percentages from logistic regression
controlling for age, health status, and, in the U.S., insurance status.
THE
COMMONWEALTH
FUND
54
Confident Will Receive Most-Effective Treatment if Sick,
by Income
(Adjusted) percent
confident/very confident
100
75
80
79
73
71
8885
Above-average income
82
78
88
87
81
78
Below-average income
91
72
86
9592
82
70
63
65
58
50
25
0
AUS*
CAN*
FR
GER
NETH*
NZ*
NOR*
SWE*
SWIZ*
Note: Percentages adjusted based on logistic regression to control for health status, age, and—in the U.S.—
insurance status.
* Indicates significant within-country differences with below-average income (p < 0.05).
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
UK
US*
THE
COMMONWEALTH
FUND
55
Cost-Related Access Problems
in the Past Year, by Income
(Adjusted) percent
experienced at least one
of three problems**
Above-average income
Below-average income
75
50
39
27
22
25
18
12
21
17 17
6
8
CAN*
FR*
13
3
20
15
8
14
12
4
5
7
NOR*
SWE*
SWIZ*
4 4
0
AUS*
GER*
NETH*
NZ*
UK
US*
Note: Percentages adjusted based on logistic regression to control for health status, age, and—in the U.S.—
insurance status.
* Indicates significant within-country differences with below-average income (p < 0.05).
** Did not fill/skipped prescription, did not visit doctor with medical problem, and/or did not get recommended care.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
THE
COMMONWEALTH
FUND
56
Out-of-Pocket Spending of $1,000 or More
in the Past Year, by Income
Above-average income
(Adjusted) percent
Below-average income
60
45
45
34
31
29
30
16 17
16 15
12
15
20
11
10
5 5
5
7
11
6
2 2
0 0
0
AUS*
CAN*
FR
GER*
NETH
NZ*
NOR
SWE
SWIZ*
Note: Percentages adjusted based on logistic regression to control for health status, age, and—in the U.S.—
insurance status.
* Indicates significant within-country differences with below-average income (p < 0.05).
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
UK
US*
THE
COMMONWEALTH
FUND
57
Serious Problems Paying or Unable to Pay
Medical Bills in the Past Year, by Income
(Adjusted) percent
Above-average income
Below-average income
40
30
24
20
13
10
10
11
9
10
7
5
2
2
1
CAN*
FR*
GER*
9
9
9
6
2
2
NZ*
1
2
2
NOR*
SWE*
SWIZ*
2 3
0
AUS*
NETH*
Note: Percentages adjusted based on logistic regression to control for health status, age, and—in the U.S.—
insurance status.
* Indicates significant within-country differences with below-average income (p < 0.05).
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
UK
US*
THE
COMMONWEALTH
FUND
58
Difficulty Getting After-Hours Care,
by Income
(Adjusted) percent reported
somewhat/very difficult
Above-average income
Below-average income
100
75
72
67
64
63
60
59
5655
6770
68
55
52
44
50
31
4342
40
37
34
47
31
25
0
AUS
CAN*
FR*
GER
NETH*
NZ
NOR*
SWE
SWIZ
Note: Percentages adjusted based on logistic regression to control for health status, age, and—in the U.S.—
insurance status. Base: Needed care and answered question.
* Indicates significant within-country differences with below-average income (p < 0.05).
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
UK*
US*
THE
COMMONWEALTH
FUND
59
Waited Two Months or Longer for
Specialist Appointment, by Income
(Adjusted) percent
Above-average income
Below-average income
75
45
50
40
26
31
35 35
29 30
26
24
25
15
8 9
3231
28
18
14
7
7
3
10
0
AUS*
CAN
FR
GER
NETH*
NZ*
NOR
SWE
SWIZ*
Note: Percentages adjusted based on logistic regression to control for health status, age, and—in the U.S.—
insurance status. Base: Needed to see specialist in past two years.
* Indicates significant within-country differences with below-average income (p < 0.05).
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
UK
US
THE
COMMONWEALTH
FUND
60
U.S. Adults Under Age 65, by Insurance and Income
19
Went without care
because of cost
46
69
46
$1,000 or more
out-of-pocket costs
33
35
Insured all year,
above-average
income
7
Serious problem or
unable to pay bill
31
47
32
36
Insurance difficulty
0
25
Insured all year,
below-average
income
Uninsured
50
Percent
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
75
100
THE
COMMONWEALTH
FUND
61
Acknowledgments and Cofunders
Thanks to to Harris Interactive, Inc., and contractors for conducting the
survey.
•
Australia: Commission on Safety and Quality in Health Care, Bureau of
Health Information
•
Canada: Health Council of Canada, Ontario Quality Council, Quebec
Health Commission
•
France: Haute Authorité de Santé (HAS), Caisse Nationale de
l’Assurance Maladie des Travailleurs Salariés (CNAMTS)
•
Germany: Institute for Quality and Efficiency in Health Care (IQWiG)
•
Netherlands: Dutch Ministry of Health, Welfare and Sport, and IQ Health,
Radboud University Nijmegen
•
Norway: Norwegian Knowledge Centre for the Health Services
•
Sweden: Swedish Ministry of Health
•
Switzerland: Federal Office of Public Health
•
United Kingdom: Health Foundation
THE
COMMONWEALTH
FUND