US Primary Care Has Few Highlights in International Survey

Electronic medical records use has increased by about 50% among US primary care physicians in the last 3 years. (Image: kokouu/

US primary care physicians are jumping aboard the information technology bandwagon to better manage patient care. But they spend more time handling insurance restrictions and their patients have more problems paying for care than in many other industrialized nations, a new survey reports.

Researchers from the Commonwealth Fund and Harris Interactive, both in New York City, conducted an international survey to examine how countries are revamping primary care through health reforms to improve health services and access to care. The researchers collected responses from a total of more than 8500 primary care physicians in the United States, Canada, the United Kingdom, France, Germany, Switzerland, the Netherlands, Norway, Australia, and New Zealand.

Survey results included the following:

  • About two-thirds (69%) of US primary care physicians use electronic medical records, up from 46% in 2009. But the figure is about 98% in the United Kingdom, Norway, New Zealand, and the Netherlands. The lowest rate, 41%, was in Switzerland.
  • About one-fourth (28%) of US primary care physicians said patients have long waits to see a specialist, compared with the low rate of 10% in Switzerland and the high of 73% in Canada.
  • About one-fifth (21%) of US primary care physicians said the quality of care their patients receive through the health system has improved in the past 3 years; 25% said it has gotten worse. The Netherlands had the highest percentage (38%) of physicians who said care improved; France had the lowest, 9%. France also had the highest percentage (37%) who said care has worsened; Norway had the lowest, 11%.
  • The United States—the only country in the survey without universal health care—had the highest percentage (59%) of primary care physicians reporting that patients have difficulty paying for services. In comparison, 4% of primary care physicians in Norway, 13% in the United Kingdom, and 16% in Switzerland said patients have payment problems.
  • The United States also had the highest percentage (52%) of physicians surveyed who said time spent handling insurance restrictions is a major problem; the lowest percentage (10%) was in Australia.
  • Only 15% of US primary care physicians, the lowest proportion in the survey, said the country’s health care system works well. The highest was in Norway, 61%.

About half or fewer physicians in the countries surveyed reported routinely being able to exchange patient information electronically with physicians outside of their practices. The figure was 14% in Canada, 31% in the United States, and a high of 55% in New Zealand.

Commonwealth Fund President Karen Davis, PhD, attributed US doctors’ increased use of electronic medical records to incentives in the 2009 economic stimulus legislation. “We hope to see similar progress as health reform provisions take hold, including patient-centered medical homes and health care systems that foster teamwork and coordination,” she said in a statement.

Categories: Medical Practice, Primary Care/Family Medicine, Public Health, Quality of Care