Posting date: October 28, 2004

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Health Affairs, 10.1377/hlthaff.w4.487
Copyright © 2004 by Project HOPE

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Primary Care And Health System Performance: Adults’ Experiences In Five Countries

¹ Cathy Schoen is vice president, Health Policy, Research, and Evaluation, at the Commonwealth Fund in New York City.
² Robin Osborn is vice president, International Health Policy and Practice, at the Commonwealth Fund.
³ Phuong Trang Huynh is a program officer at the Commonwealth Fund.
⁴ Michelle Doty is a senior analyst at the Commonwealth Fund.
⁵ Karen Davis is president of the Commonwealth Fund.
⁶ Kinga Zapert is vice president of Harris Interactive in New York City.
⁷ Jordan Peugh is a senior research manager at Harris Interactive.

^*Corresponding author.

Abstract

This paper reports on a 2004 survey of primary care experiences among adults in Australia, Canada, New Zealand, the United Kingdom, and the United States. The survey finds shortfalls in delivery of safe, effective, timely, or patient-centered care, with variations among countries. Delays in lab test results and test errors raise safety concerns. Failures to communicate, to engage patients, or to promote health are widespread. Aside from clinical preventive care, the United States performs poorly on most care dimensions in the study, with notable cost-related access concerns and short-term physician relationships. Contrasts across countries point to the potential to improve performance and to learn from international initiatives.

Key Words: Consumer Issues, International Issues, Public Opinion, Quality Of Care, Health Spending

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