The Commonwealth Fund 2000 International Health Policy Survey of Physicians

Transcription

1 The Commonwealth Fund 2000 International Health Policy Survey of Physicians Accompanies May/June 2001 Health Affairs article Charts Originally Presented at the 2000 International Symposium on Health Care Policy

2 The Commonwealth Fund 2000 International Health Policy Survey of Physicians 2 Survey of about 500 physicians in five countries: Australia (517), Canada (533), New Zealand (493), United Kingdom (500) and United States (528) Conducted by Harris Interactive and subcontractors from April 27 through July 27, 2000 Specialists restricted to: cardiologists, gastroenterologists and oncologists Conducted by mail, with an online option, or telephone. Margin of error per country + or - 4 percentage points

3 Percent Who Think Their Ability to Provide Quality Care Has Gotten Worse in the Past Five Years 3 100% Generalist MDs Specialists* 75% 50% 38% 41% 67% 59% 54% 42% 45% 49% 56% 60% 25% 0% AUS CAN NZ UK US * Cardiologists, gastroenterologists, and oncologists.

4 Concerns About the Future 4 Percent very concerned AUS CAN NZ UK US Quality of care will decline Patients will not be able to afford the care they need Patients will wait longer than they should for medical treatment Base: Generalist MDs

5 Protecting Against Medical Errors 5 Percent rating their hospital as fair or poor on finding and addressing medical errors 75% 50% 25% AUS CAN NZ UK US 56% 51% 51% 45% 45% 48% 46% 36% 29% 33% 0% Generalist MDs Cardiologists, gastroenterologists, and oncologists Note: Some report no tracking process.

6 Reporting of Medical Errors 6 Percent of specialists who say hospital staff are discouraged or not encouraged to report medical errors AUS CAN NZ UK US 75% 64% 50% 38% 46% 28% 44% 25% 0% Cardiologists, gastroenterologists, and oncologists

7 Improved Systems for Reducing Medical Errors 7 Percent who say that improved systems for reducing medical errors would be highly effective AUS CAN NZ UK US 75% 50% 64% 53% 56% 59% 54% 54% 56% 49% 47% 48% 25% 0% Generalist MDs Cardiologists, gastroenterologists, and oncologists

8 8 Use of Electronic Medical Records Percent of doctors who report using electronic medical records Primary Care Specialists 80% 52% 59% 40% 25% 13% 14% 16% 14% 22% 17% 12% 0% AUS CAN NZ UK US

9 Use of Electronic Prescribing of Prescription Drugs 9 Percent of doctors who report using electronic prescribing of drugs often Primary Care Specialists 100% 87% 50% 44% 52% 12% 8% 11% 14% 16% 9% 6% 0% AUS CAN NZ UK US

10 Satisfaction with Nursing Staff Levels in Their Hospital 10 Proportion saying nursing staff levels are fair or poor in their hospital AUS CAN NZ UK US 100% 75% 50% 84% 83% 62% 68% 72% 65% 66% 70% 64% 52% 25% 0% Generalist MDs Cardiologists, gastroenterologists, and oncologists

11 Adequacy of Community Medical Resources Staff, Equipment, and Facilities 11 Percent reporting too little/too few Latest medical and diagnostic equipment AUS CAN NZ UK US Hospital beds General practitioners Medical specialists or consultants Home care Long-term care and rehabilitation facilities Base: Generalist MDs

12 Ratings of Hospital Resources 12 Percent rating hospital as fair or poor AUS CAN NZ UK US Nursing staff levels Emergency room facilities Base: Cardiologists, gastroenterologists, and oncologists

13 Major Problems in Medical Practice 13 Percent reporting major problem Limitations on or long waits for specialist referrals Long waiting times for surgical or hospital care Patients cannot afford necessary prescription drugs Limitations on drugs you can prescribe your patients Not having enough time with patients External review of clinical decisions to control costs AUS CAN NZ UK US Base: Generalist MDs

14 Perceptions of Patient s Problems 14 Percent reporting often Patients have difficulty affording out-of-pocket costs Patients do not receive preventive care Patients lack access to newest drugs or medical technology Patients get sicker because they are not able to get the health care they need AUS CAN NZ UK US Base: Generalist MDs

15 15 Waiting Times for Treatment Breast Biopsy Percent reporting AUS CAN NZ UK US A 50 year old woman with an illdefined mass in her breast, but no adenopathy, would wait: Less than 1 week weeks weeks More than 1 month Base: Generalist MDs

16 Waiting Times for Treatment Hip Replacement 16 Percent reporting AUS CAN NZ UK US A 65-year-old man who requires a routine hip replacement Would wait less than 1 week Would wait 1 week to less than month Would wait 1 to 6 months Would wait more than 6 months Base: Generalist MDs

17 Usefulness of Quality Information 17 Percent saying very useful AUS CAN NZ UK US Electronic prescribing of drugs Electronic patient medical records Comparisons of medical outcomes of selected procedures Treatment guidelines or protocols Reports from patients and families about satisfaction with care Profiles comparing doctors practices relative to peers Base: Generalist MDs

18 Ways to Improve Quality of Care 18 Percent saying highly effective AUS CAN NZ UK US Spending more time with patients Better access to specialized medical care Better access to new prescription medications Improved systems for reducing medical errors Better nursing or home care follow up after discharge Better access to preventive care and patient education Base: Generalist MDs

19 Release of Quality Information on Hospitals to the Public 19 Percent favoring release to the public 100% 75% AUS CAN NZ UK US 83% 75% 74% 78% 80% 83% 78% 72% 66% 60% 50% 25% 0% Generalist MDs Cardiologists, gastroenterologists, and oncologists

20 Satisfaction with Ability to Keep Up with Developments 20 Proportion saying they are very satisfied with their ability to keep up AUS CAN NZ UK US 50% 25% 32% 23% 23% 20% 15% 40% 41% 43% 26% 19% 0% Generalist MDs Cardiologists, gastroenterologists, and oncologists

21 Overall View of Health Care System: Generalist MDs vs. The Public 21 System works well minor changes needed Some good things fundamental change needed System needs complete rebuilding AUS CAN NZ UK US Public MDs Public MDs Public MDs Public MDs Public MDs Doctor Base: Generalist MDs Public: 1998 Survey Adults and Commonwealth Fund 1998 International Health Policy Survey

22 Satisfaction with Medical Practice 22 Percent reporting very satisfied or somewhat satisfied Somewhat satisfied Very satisfied 100% 75% 50% 72% 72% 73% 63% 68% 21% 19% 14% 12% 18% 25% 0% 51% 53% 51% 59% 50% AUS CAN NZ UK US Base: Generalist MDs

23 Methodology The Commmonwealth Fund 2000 International Health Policy Survey of Physicians elicited the health care system views and experiences of physicians in five nations Australia, Canada, New Zealand, the UK, and the US. The survey was conducted by a combination of mail, telephone, and internet by Harris Interactive in the United States and its subcontractors in the four other countries. In four of the countries, interviews were conducted in English only; in Canada, they were conducted in both French and English. Conducted from April 27, 2000 to July 27, 2000, the survey resulted in final samples of 517 physicians in Australia, 533 in Canada, 493 in New Zealand, 500 in the United Kingdom and 528 in the United States. 23 To obtain a comparable representation of both generalists and specialist physicians, the sample was stratified into two categories: generalist physicians general practitioners and primary care physicians and a sample of medical specialists, limited to cardiologists, gastroenterologists and oncologists. This ratio of generalists to medical specialists is the norm found in four countries. Only in the U.S. are medical specialists found in a higher proportion to generalists. Approximately 400 randomly selected generalist physicians and 100 medical specialist physicians were interviewed in each country. The physicians were selected from lists of practicing physicians in each country that were available through private or government sources.