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Health Care in America-Not a Rosy Picture

Getting appointments after hours with a nurse or primary care physician without going to an emergency room, in America is more difficult than in several other countries// according to a study released on Thursday.

A survey of over 6,000 physicians in seven countries revealed that they had arrangements for after-hours care. This included 95 percent in the Netherlands, 90 percent in New Zealand, 87 percent in the United Kingdom, 76 percent in Germany and 47 percent in Canada compared to 40 percent of doctors in US.

This study was published online by the journal Health Affairs and it revealed that the United States trails other countries in the adoption of electronic medical records and computerized systems which remind patients about follow-up care, prompt physicians to give patients test results and warn of potentially harmful drug interactions. In addition it was found that primary care doctors in America were less likely to have financial incentives to improve the quality of the care they provide.

Karen Davis, president of the Commonwealth Fund, the foundation that sponsored the survey, said, "Although the U.S. pays more for health care than any other country, we are under-investing in our primary care system. Other countries have made high-quality primary care a priority by putting into place the financial and technical systems that support access to, and delivery of, such care."

Like many other previous studies, this study also concludes that the United States lags on some measures of health and care despite spending more on medical care than any other nation. Statistics have shown that the annual U.S. medical expenditure was $5,635 per person in 2003. This was followed by Canada with an expenditure of $3,003 per person. Netherlands was seen to spend the least, at $1,886 per person. The survey also revealed that U.S. primary care doctors were the most likely to say their patients often had difficulty paying for medications or o ther care, the survey found.

Health care advocates say greater use of electronic records would improve patient care, curb unnecessary tests, reduce errors and cut paperwork. 28 percent of U.S. primary care doctors said that they used such records, compared with 98 percent in the Netherlands, 92 percent in New Zealand, 89 percent in the United Kingdom, 79 percent in Australia and 42 percent in Germany. Only Canada ranked lower, at 23 percent.

It was also seen that twenty-three percent of U.S. physicians said they had a computerized system to alert them to a potential problem with a drug dose or interaction. Physicians in most other countries reported using such systems. The Netherlands was highest at 93 percent. The United States and Canada also ranked lower than the others in use of computerized systems to remind patients to get follow-up care or to remind doctors to give patients test results.

Although most policymakers say physicians should be rewarded for the quality, instead of only volume, of services only 30 percent of U.S. doctors said they have financial incentives to improve the quality of the care they provide. However in the United Kingdom 95 percent of doctors said they received such incentives. The survey revealed United States to be the last.

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