The United States is lagging behind the rest of the industrial world in several areas of primary care, including financial incentives, according to the Commonwealth Fund 2006 International Health Policy Survey.
The findings of the survey, which evaluated the primary care systems of the United States, United Kingdom, Australia, New Zealand, Germany and the Netherlands, were presented at the Commonwealth Fund’s International Symposium on Healthcare Policy.
Access to primary care, insurance, drug safety systems, implementation of IT, use of teams and quality incentives were among the criteria used to evaluate primary care systems. The United States scored low in areas such as after-hours access and safety systems, and markedly underperformed in areas involving finance.
“Very few U.S. doctors say they have financial incentives,” said Karen Davis, president of the Commonwealth Fund. According to the survey, primary care doctors in the United States are the least likely to report financial incentives for quality or special treatments. The United States was also the one nation surveyed that has a high uninsured population. “Our doctors are the most likely to say that their patients have difficulty paying for care,” said Davis.
For their successful implementation of pay-for-performance systems, the United Kingdom, Australia and New Zealand were standouts in the payment policies category. The survey noted that the United States and Canada “do not yet have national payment initiatives that focus on physicians and primary care.”
In IT investment, the United States and Canada scored far below the other nations. U.S. and Canadian IT implementation has been hindered because of reliance on “market-driven individual care systems or physician investment,” the survey found.
Carolyn Clancy, MD, director for the Agency for Healthcare Research and Quality, said, “The findings underscore the importance of looking at what needs to be achieved in primary care.”
She stressed the importance of pluralism in considering future challenges: “We’re going to learn about our capacity to improve quality through these collaborative projects.”