The worst healthcare system for older people

US worse for elderly people

Adults in the US are sicker and struggle most with medical bills in an international survey.

An international survey from the Commonwealth Fund has found the United States to be among the worst countries when it comes to receiving and affording health care for elderly people. The study of older people in 11 developed countries revealed US adults tend to be sicker than those in other countries, and also the most likely to struggle with medical bills.

The 2014 Commonwealth Fund International Health Policy Survey of Older Adults questioned more than 15,000 people age 65 and older in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the U.S.

The study authors note that while all the countries could be doing better in terms of providing healthcare for their older population, the U.S. is home to the sickest adults. The majority (87%) of Americans surveyed reported suffering from one chronic illness such as diabetes, high blood pressure, or heart disease. Over two-thirds (68%) have two or more chronic conditions.

Additionally, the U.S. stood out due to the fact more than half (53%) of respondents reported taking four or more medications – the highest among countries surveyed. In addition a quarter of elderly American patients reporting seeing four or more doctors in the past year, this is second only to Germany (39%).

Canadian, Swedish, Norwegian, and American patients were the least likely to be able to get same or next day doctor’s appointments. They were also the least likely to find it somewhat or very easy to get after-hours care without using the emergency department.

Despite the burden chronic illnesses place on health systems, the U.S., along with the UK, did well in areas related to managing chronic conditions. Over half (58%) of chronically ill respondents in the U.S., and 59 percent in the UK, had discussed their treatment goals with their doctor and were given clear instructions on when to seek further help. This compares with fewer than half of chronically ill people in the other nine countries.

Cost barrier

Despite having Medicare coverage, U.S. adults aged 65 or older were the most likely to report that cost posed a barrier to accessing healthcare. One-fifth (19%) even cited cost as a reason they didn’t seek treatment, have a test, fill a prescription or miss doses of their prescribed medication.

The study highlighted the fact U.S. respondents were the most likely to report having trouble paying their medical bills (11%). This compares with only 1 percent of respondents in Norway and Sweden reporting the same.

“Although there is still much room for improvement for the U.S., as well as among other nations, it is encouraging to see the U.S. health system doing well for older adults in areas like better managing chronic illness, which have been the focus of concentrated efforts for improvement,” said Commonwealth Fund President David Blumenthal, M.D.