How High-Need Patients Experience the Health Care System in Nine Countries

Brief
Key Questions Answered
  • How does the U.S. compare with other high-income countries in terms of care for high-need individuals?
  • What lessons can the U.S. learn from other countries?
Key Themes and Takeaways

This resource reviews Commonwealth Fund survey data focused on high-need adults ages 65 and older in nine countries — Australia, Canada, France, Germany, the Netherlands, Norway, Sweden, Switzerland, and the United States. Findings included the following:

  • The U.S. had the highest percentage of older adults with three or more chronic conditions (42 percent).
  • The U.S. had the highest rate of cost-related access problems for all older adults, especially high-need patients. More than 1 in 5 high-need adults in the U.S. (22 percent) reported cost-related barriers to care.
  • The U.S. performed better than all the other countries in contacting patients between visits and providing treatment plans. Nearly 9 of 10 high-need adults in the U.S. (87 percent) reported that they had a treatment plan.
  • Success in other countries may be the result of policies that specifically target high-need patients. Further analysis of these policies and their key features can help U.S. policymakers better target care to high-need patients.
Authors
Dana O. Sarnak
Jamie Ryan
Population Addressed
Adults Under 65 with Disabilities
Frail Older Adults
People with Multiple Chronic Conditions
People with Behavioral Health and Social Needs
Level of Evidence
Rigorous Observational Study; Moderate Evidence
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