United States Health Care: First in Spending, Last in Results

Out of 11 countries examined in a recent study, the United States health care system finished last on most dimensions of performance for the fifth time since 2004. The United Kingdom and Switzerland rank one and two in the study.

The Commonwealth Fund is a private foundation that strives to promote high performing health care systems in regards to better access, improved quality, and greater efficiency, most notably for uninsured, minorities, young children, and the elderly. They looked at the health care systems of Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the U.S.

They found that the United States fails to achieve better health outcomes than other countries in terms of access, efficiency, and equity. The same 11 countries were studied in 2010, when U.S. also came in last. The researchers ranked each country based on quality care, effective care, safe, care, coordinated care, patient-centered care, access, cost-related problem, timeliness of care, efficiency, equity, healthy lives, and health expenditures per capita.

The United States ranked last in cost-related problems, efficiency, equity, healthy lives, and health expenditures per capita. The U.S. cost per capita (based on the most recent national health system scorecard from 2011) was $8,508, which was $2,839 more than the next closest nation (Norway). The highest ranking for the U.S. was in effective care, where they placed third out of the eleven countries.

"Many U.S. hospitals and health systems are dedicated to improving the process of care to achieve better safety and quality, but the U.S. can also learn from innovations in other countries-including public reporting of quality data, payment systems that reward high-quality care, and a team approach to management of chronic conditions," the report concluded.

In contrast to the U.S., the United Kingdom ranked first in every category except equity (placing second) and timeliness of care (placing third). Additionally, their health expenditures per capita were only $3,405, which was the lowest of any country studied. The Commonwealth Fund provided a Powerpoint chart as well as an overview of the major findings for quality, access, efficiency, equity, and healthy lives.