Nearly a quarter of U.S. primary care physicians (24 percent) say their practices are not prepared to manage the care of patients with multiple chronic conditions, and 84 percent are not prepared to treat patients with severe mental illness, according to the Commonwealth Fund's 2015 International Health Policy Survey.
These findings are alarming given that the U.S. has a higher proportion of patients with multiple chronic illnesses compared with the other nine nations surveyed by the Commonwealth Fund: Australia, Canada, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom.
"It's concerning that one in four U.S. primary care doctors don't think their practices are prepared for the sickest patients, especially when we have so many Americans with multiple chronic illnesses who may get sicker as they age," said Robin Osborn, lead author of the study and vice president of the International Program in Health Policy and Practice Innovations at The Commonwealth Fund, according to the report. "To be sure there is affordable, high-quality health care for sick and complex patients, we need to continue to strengthen primary care in the U.S."
Access to care and support for chronically ill patients differed from nation to nation. According to the report, only 39 percent of PCPs in the U.S. had arrangement for patients to access care after hours without going to the emergency room, compared with 94 percent in the Netherlands, 92 percent in New Zealand and 89 percent in the U.K. More than 80 percent of PCPs in the Netherlands and the U.K indicated they frequently make home visits, compared to 6 percent of PCPs in the U.S.
However, the U.S. physicians have made substantial improvements when it comes to using health IT, according to the report. EMR adoption has increased by 15 percent in the last three years and tripled since 2006. Sixty percent of U.S. primary care practices allow patients to access their EMR electronically, the highest percentage of any nation in the survey. Additionally, 57 percent of U.S. PCPs use email to communicate with patients.