JANUARY

Table 3. Selected Health System Performance Indicators for 11 Countries
Adults’ access to
care, 2013
New
United United
Australia Canada France Germany Netherlands Zealand Norway Sweden Switzerland Kingdom States
Able to get same-day/next-day appointment when sick 58% 41% 57% 76% 63% 72% 52% 58% n/a 52% 48%
Very/somewhat easy getting care after hours 46% 38% 36% 56% 56% 54% 58% 35% 49% 69% 39%
Waited 2 months or more for specialist appointment a 18% 29% 18% 10% 3% 19% 26% 17% 3% 7% 6%
Waited 4 months or more for elective surgery b 10% 18% 4% 3% 1% 15% 22% 6% 4% n/a 7%
Experienced access barrier because of cost in past year c 16% 13% 18% 15% 22% 21% 10% 6% 13% 4% 37%
Safety problems
among sicker
adults, 2014 o,p Health professional did not review their prescriptions in past year 16% 16% 47% 19% 37% 23% 37% 48% 27% 21% 14%
Care coordination
Experienced a coordination problem in past 2 years d 21% 32% 7% 41% 21% 20% 37% 24% 29% 24% 35%
and transitions
among older
adults, 2014 o Experienced gaps in hospital discharge planning in past 2 years e 41% 44% 54% 56% 59% n/a 70% 67% 56% 38% 28%
Chronic care
management Had a treatment plan they could carry out in daily life 80% 76% 62% 30% 41% 64% 53% 41% 47% 73% 83%
adults, 2014 n,o Between visits, has health care professional they can contact to ask
questions or to get advice
65% 67% 53% 43% 83% 75% 55% 75% 58% 71% 84%
among older
Primary care Routinely receives and reviews clinical outcomes data 35% 23% 43% 44% 88% 65% 32% 79% 9% 86% 52%
practices receive
performance Routinely receives and reviews patient satisfaction and experience data 46% 17% 3% 25% 61% 60% 9% 88% 15% 88% 63%
feedback, 2015
Routinely receives data comparing performance to other practices 13% 17% 49% 29% 42% 61% 4% 55% 37% 71% 37%
OECD health care Diabetes lower extremity amputation rates per 100,000 population, 2013 4.5 7.4 7.5 9.2 4.7 k 5.9 j 5.7 4.1 3.1 j 3.1 n/a
quality indicators i Breast cancer five-year survival rate, 2008–2013 (or nearest period) 88% q n/a 86.2% 85.8% r 85.3% 86.0% 89.8% r 89.4% n/a 81.1% 88.9% q
Mortality after admission for acute myocardial infarction
per 100 admissions over age 45, 2013 g 4.1 m 6.7 7.2 8.7 7.6 m,k 6.6 6.7 4.5 m 7.7 7.6 5.5
Avoidable deaths,
2013 Mortality amenable to health care h (deaths per 100,000 population) 68 k 78 k 64 k 88 72 89 k 69 72 n/a 86 115 l
Prevention, 2013 i Percentage of children with measles immunization 94% 95% 89% 97% 96% 92% 93% 97% 93% 95% 91%
Public views of
health system,
2013
Percentage of population over age 65 with influenza immunization n/a 64% 52% 58.6% j 69% 69% 21% 46% 46% l 76% 67% j
Works well, minor changes needed 48% 42% 40% 42% 51% 47% 46% 44% 54% 63% 25%
Fundamental changes needed 43% 50% 49% 48% 44% 45% 42% 46% 40% 33% 48%
Needs to be completely rebuilt 9% 8% 11% 10% 5% 8% 12% 10% 7% 4% 27%
Sources (unless noted otherwise): 2013, 2014, and 2015 Commonwealth Fund International Health Policy Surveys.
a Base: Saw or needed to see a specialist in past two years.
b Base: Needed elective surgery in past two years.
c
Did not fill/skipped prescription, did not visit doctor with medical problem, and/or did not get recommended care.
d
Test results/medical records not available at time of appointment and/or doctors ordered medical test that had already been
done; received conflicting information from different doctors; and/or specialist lacked medical history or regular doctor was not
informed about specialist care.
e When discharged from the hospital: you did not receive written information about what to do when you returned home and
symptoms to watch for; hospital did not make sure you had arrangements for follow-up care; someone did not discuss with
you the purpose of taking each medication; and/or you did not know who to contact if you had a question about your condition
or treatment. Base: hospitalized overnight in the past two years.
f Base: Has a regular doctor or place of care.
g In-hospital case-fatality rates within 30 days of admission.
h Source: WHO Mortality files (number of deaths by age group) and populations (except Human Mortality Database for CAN,
UK, and US). List of amenable causes: Nolte E, McKee M. Variations in amenable mortality—Trends in 16 high-income nations.
Health Policy. 2011 Sep.
i Source: OECD Health Data 2015.
j 2012.
k 2011.
l 2010.
m Admissions resulting in a transfer are included.
n Who had at least one chronic condition.
o Age 65 or older.
p Who are taking four or more prescription medications regularly.
q 2006–11.
r 2006–12.
8
The Commonwealth Fund