Primary care in the U.S. lags behind other high-income countries in many ways, including access and continuity, according to an analysis released March 15 by the Commonwealth Fund.
For the analysis, researchers examined performance of the healthcare systems in 11 high-income countries using data from the Commonwealth Fund's 2019 and 2020 international surveys, as well as data from the Commonwealth Fund's 2020 International Profiles of Health Care Systems. Researchers specifically analyzed performance in four areas: accessibility; care continuity; comprehensiveness of care; and care coordination. More information about the methodology is available here.
Five findings from the analysis:
1. Among the 11 countries studied, adults in the U.S. and Sweden are the least likely to have a regular physician or place of care.
2. U.S. primary care physicians are significantly less likely to offer home visits than physicians in the other 10 countries studied.
3. U.S. primary care physicians are the least likely among wealthy countries to report having after-hours arrangements for their patients. In contrast, nearly all primary care physicians in Germany, the Netherlands, New Zealand and Norway have these arrangements.
4. Fewer than half of U.S. primary care physicians reported adequate coordination with specialists and hospitals. That's about average for the 11 studied countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the U.S.
5. Among the 11 countries studied, U.S. primary care providers are most likely to screen for social service needs. But the analysis also found U.S. adults are more likely to worry about their social needs being met — especially compared to adults in Germany, the Netherlands, Norway and Sweden.
The Commonwealth Fund attributed the findings to decades of chronic underinvestment in primary care in the U.S., as well as low provider supply. They provided several policy options for U.S. policymakers to consider, including narrowing the wage gap between generalist and specialist physicians and financial incentives to facilitate communication between patients' providers.
Read the full study here.