Medical.

Survey Finds High Rate of Medical Errors and
Lack of Communication Between Doctor and Patient
Press Release Provided by The Commonwealth Fund
New York City, May 6, 2003–A Commonwealth Fund/Harvard/Harris Interactive survey
of patients with health problems in the United States and four other industrialized
countries reveals disturbingly high rates of medical errors, lack of coordination
in patient care, poor communication between doctors and patients, and barriers
when accessing care. The findings, published today in a Health Affairs article,
point to widespread error, inefficiency, and missed opportunities in the health
systems of Australia, Canada, New Zealand, the United Kingdom, and the U.S.
The authors suggest that reforms targeted to populations with health problems
could reap system-wide improved quality and potential cost savings.
“Frequent error, miscommunication, and wasted resources from duplicate
tests, delays, and conflicting information are common problems in the health
systems of all the countries studied,” said Karen Davis, president of The
Commonwealth Fund. “These findings highlight serious problems with quality
of care and wasted resources, and make a compelling case for implementing interventions
that we know will make a difference, including electronic medical records and
computerized systems for physician ordering of prescription drugs.”
The article, “Common Concerns Amid Diverse Systems: Health Care Experiences
in Five Countries,” discusses findings from a survey of the health care
experiences of patients age 18 or older who reported fair or poor health, a
serious illness, injury, or disability, or major surgery or hospitalization
for something other than a normal delivery in the past two years. It was prepared
by health policy analysts Robert J. Blendon and Catherine DesRoches of the Harvard
School of Public Health, Cathy Schoen and Robin Osborn of The Commonwealth Fund,
and Kinga Zapert of Harris Interactive.
Medication and Medical Errors
One-fourth of adults with health problems in Australia, Canada, New Zealand,
and the U.S. and one-fifth of this population in the U.K., reported they had
experienced a medication error or medical error in the past two years. Among
those reporting a medication or medical error, majorities in every country said
the error caused serious health consequences. As a result, among all respondents,
the percent reporting an error that caused serious health problems was 13% in
Australia, 15% in Canada, 14% in New Zealand, 9% in the United Kingdom, and
18% in the U.S.
Care Coordination Problems
Lack of coordination of care was a problem for significant proportions of patients.
One of five sicker adults in Canada (20%) and the U.S. (22%) reported being
sent for duplicate tests by different health professionals, as did one of six
in New Zealand (17%) and one of eight in Australia (13%) and the U.K. (13%).
In all five countries, about half the individuals said they had to repeat their
health history to multiple health professionals (US=57%, CAN=50%, AUS=49%, UK=49%,
NZ=47%).
One-fourth of U.S. (25%) and U.K. (23%) respondents, one-fifth (19%) of Canadian
respondents, and one of six in Australia (14%) and New Zealand (16%) said that
their medical records did not reach a doctor’s office in time for an appointment.
About one-fourth of respondents in Australia, Canada, New Zealand, and the U.S,
and one-fifth in the U.K. (19%), reported receiving conflicting information
from different health professionals.
Physician-Patient Communication
U.S. patients were more likely than those in the other countries to report communication
difficulties with their physicians. Three of 10 respondents in the U.S. (31%)
said they left a doctor’s office without getting important questions answered,
compared with one of five in Australia (21%), New Zealand (20%), and the U.K.
(19%), and one of four Canadians (25%). Two of five (39%) U.S. respondents said
they did not follow a doctor’s advice, compared with three of 10 in Australia
(31%) and Canada (31%), one of four in New Zealand (27%), and one of five (21%)
in the U.K. The primary reasons given for not following a doctor’s advice was
that they did not agree with the doctor’s recommendations or the advice was
too difficult to follow.
A surprisingly high proportion of adults with health problems–half of those
in Australia, Canada, New Zealand, and the U.S., two-thirds in the U.K.–reported
their regular doctor does not ask for their ideas and opinions about treatment
and care. From one-fifth to one-quarter of respondents in four countries, and
two of five in the U.K., said their doctor did not make clear specific goals
for treatment.
Half of respondents in four countries (CAN=55%, AUS=54%, NZ=54%, US=51%) and
two-thirds (66%) of U.K adults with health problems said their physician had
not discussed the emotional burden of coping with their condition.
Underscoring further concerns about both quality of care and ensuring that
health expenditures are actually benefiting patients, the survey found that
more than one in six adults with health problems stopped taking prescription
medications without their doctor’s advice, because of the side effects (US=19%,
CAN=17%, NZ and UK=16%, AUS=15%).
Access and Cost Problems
Not surprisingly, a higher proportion of U.S. respondents compared with the
four other countries said they encountered problems accessing health care because
of the cost-although cost did affect access to some extent in all the countries.
In the U.S., one-third of adults with health problems did not fill a prescription
(35%), and one-fourth did not get medical care (28%) or a recommended test,
treatment, or follow-up (26%), due to cost.
Respondents in other countries also cited cost-related access problems: one-fifth
of respondents in Australia (23%), Canada (19%), and New Zealand (20%) said
they did not fill a prescription due to cost, although only 10 percent of U.K.
respondents reported the same. One-fourth (26%) of adults with health problems
in New Zealand said they did not get medical care because of cost, as did one
of six (16%) Australian respondents. U.K. respondents were least likely to report
access problems due to cost: 4 percent cited cost as the reason they did not
get medical care, and 5 percent said it was the reason they did not get a recommended
test, treatment, or follow-up.
About one of six (16%) U.S. adults with health problems said they skipped doses
to make their medication last longer, while fewer than 10 percent of those in
the other four countries reported skipping medication doses.
Article Summary