Health Affairs

Health Affairs, 28, no. 1 (2009): w1-w16 (Published online 13 November 2008) doi: 10.1377/hlthaff.28.1.w1 © 2009 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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In Chronic Condition: Experiences Of Patients With Complex Health Care Needs, In Eight Countries, 2008

Cathy Schoen, Robin Osborn, Sabrina K.H. How, Michelle M. Doty and Jordon Peugh

This 2008 survey of chronically ill adults in Australia, Canada, France, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States finds major differences among countries in access, safety, and care efficiency. U.S. patients were at particularly high risk of forgoing care because of costs and of experiencing inefficient, poorly organized care, or errors. The Dutch, who have a strong primary care infrastructure, report notably positive access and coordination experiences. Still, deficits in care management during hospital discharge or when seeing multiple doctors occurred in all countries. Findings highlight the need for system innovations to improve outcomes for patients with complex chronic conditions.

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