We analyzed 2011 survey data of patients with complex health care needs in 11 countries (Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States) on their care experiences. Wide country variation was reported in how well patients were engaged by their clinicians; UK and Swiss patients reported the most positive experiences, but gaps were reported in all countries. Disparities by income were found in several countries, with the widest gaps reported in the United States. Across countries, engaged patients reported receiving higher-quality care, fewer errors, and more positive views of the health system.
International Program in Health Policy and Innovation, The Commonwealth Fund, New York.
Correspondence: Robin Osborn, MBA, International Program in Health Policy and Innovation, The Commonwealth Fund, 1 E 75th St, New York, NY 10021 (firstname.lastname@example.org).
The authors thank Tony Shih and Cathy Schoen for their very helpful feedback on this manuscript. Findings from the 2011 Commonwealth Fund International Survey, including some data presented in this article, were published in Schoen, C., Osborn, R., Squires, D., Doty, M. M., Pierson, R., & Applebaum, S. (2011). New 2011 survey of patients with complex care needs in eleven countries finds that care is often poorly coordinated. Health Affairs, 30(12), 2437-2448.
Conflicts of Interest and Sources of Funding: The Commonwealth Fund provided core support for the 2011 International Health Policy Survey in Eleven Countries, with cofunding to include countries from the German National Institute for Quality Measurement in Health Care; Haute Authorité de Santé and Caisse Nationale d'Assurance Maladie des Travailleurs Salariés (France); Dutch Ministry of Health, Welfare, and Sport and the Scientific Institute for Quality of Healthcare at Radboud University Nijmegen; Norwegian Knowledge Centre for the Health Services; Swedish Ministry of Health and Social Affairs; and the Swiss Federal Office of Public Health. Support to expand samples was provided by the U.K. Health Foundation; the Bureau of Health Information (Australia); and the Health Council of Canada, Health Quality Council of Alberta, Ontario Health Quality Council, and Québec Health Commission.
No conflicts of interest are declared.
The views expressed are those of the authors and should not be attributed to the Commonwealth Fund, its directors, or its officers.