International survey of older adults finds shortcomings in access, coordination, and patient-centered care

Health Aff (Millwood). 2014 Dec;33(12):2247-55. doi: 10.1377/hlthaff.2014.0947. Epub 2014 Nov 19.

Abstract

Industrialized nations face the common challenge of caring for aging populations, with rising rates of chronic disease and disability. Our 2014 computer-assisted telephone survey of the health and care experiences among 15,617 adults age sixty-five or older in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States has found that US older adults were sicker than their counterparts abroad. Out-of-pocket expenses posed greater problems in the United States than elsewhere. Accessing primary care and avoiding the emergency department tended to be more difficult in the United States, Canada, and Sweden than in other surveyed countries. One-fifth or more of older adults reported receiving uncoordinated care in all countries except France. US respondents were among the most likely to have discussed health-promoting behaviors with a clinician, to have a chronic care plan tailored to their daily life, and to have engaged in end-of-life care planning. Finally, in half of the countries, one-fifth or more of chronically ill adults were caregivers themselves.

Keywords: Access To Care; Chronic Care; Developed World < International/global health studies; Long-Term Care; Medicare.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Chronic Disease / epidemiology
  • Chronic Disease / therapy
  • Continuity of Patient Care / statistics & numerical data
  • Developed Countries / statistics & numerical data
  • Health Care Costs / statistics & numerical data
  • Health Care Surveys
  • Health Services Accessibility / statistics & numerical data*
  • Health Services for the Aged / organization & administration
  • Health Services for the Aged / statistics & numerical data
  • Humans
  • Patient Safety / statistics & numerical data
  • Patient-Centered Care / statistics & numerical data*
  • Physician-Patient Relations
  • Terminal Care / statistics & numerical data