Figure ES-1. Difficulty Getting Care on Nights, Weekends, Holidays Without Going to ER Percent...

Figure ES-1. Difficulty Getting Care on Nights, Weekends, Holidays Without Going to ER

Percent saying “very” or “somewhat difficult”

5360

3242

70

56 59

3244

60

0

25

50

75

100

Australia Canada New

Zealand

United

Kingdom

United

States

Below average income Above average income

* Significant difference between below and above average income groups within country at p<.05.Source: Commonwealth Fund 2004 International Health Policy Survey.

*

Figure ES-2. Under 65: Lab Test Errors—Comparisons with U.S. Insured and Uninsured

9 12 159

16 13

27

0

25

50

75

AUS CAN NZ UK Total Insured Uninsured

Percent given wrong result or delay in receiving abnormal test result

United States

Base: Under 65 who have had lab tests in past two years

* *

*

* Significantly different from U.S. insured at p<.05.Uninsured = uninsured at time of survey or any time during the year.Source: Commonwealth Fund 2004 International Health Policy Survey.

Figure 1. Insurance and Cost-Sharing Policiesin Four Countries with Universal Public Coverage

AUS CAN NZ UK

Private insurancefor services covered by public

Permitted only for hospital services

Prohibited for core services in most

provincesPermitted Permitted

Percent with private coverage

49%

79.9%

(to cover benefits excluded from ‘free-of charge’

public plan)

33% 12%

Public Plan Patient Cost-Sharing

Variable depending on

service type and provider

None for core services

Copayments for many services

None for basic services (except Rx and optical)

Prescription Drugs Covered

Publicly covered for social

assistance beneficiaries and in most provinces for

seniors

Covered Covered

Source: B. K. Frogner and G. F. Anderson, Multinational Comparisons of Health Systems Data, 2005(New York: The Commonwealth Fund, Apr. 2006).

Figure 2. Private Insurance in Four Countrieswith Universal Coverage

3036

1911

63

81

57

35

0

25

50

75

100

Australia Canada New Zealand United

Kingdom


Percent who have private insurance in addition to public

**

*


*

Figure 3. Insurance Profile of U.S. Adults by Income

12

40

88

58

0 25 50 75 100

Above

average

income

Below

average

income

Uninsured Insured all year

* *

Uninsured = uninsured at time of survey or any time during the year.Below average income numbers do not add up to 100% because of not sure/decline to answer.* Significant difference between below and above average income groups within country at p<.05.Source: Commonwealth Fund 2004 International Health Policy Survey.

Figure 4. Spent More than US$1,000 Out-of-Pocketfor Medical Care in Past Year, by Income

8 104 2

2421

126 5

32

0

25

50

75


Zealand

United

Kingdom

United

States


**

*

Percent


Figure 5. Health Status by Income

Percent: AUS CAN NZ UK US

Fair/Poor Health:

Below Average 22* 19* 22* 24* 30*

Above Average 7 7 6 8 6

Any of 6 Chronic Illnesses:^

Below Average 63* 58* 62* 64* 62*

Above Average 41 42 40 39 42

^ Chronic illnesses include: hypertension, heart disease, diabetes, arthritis, lung problems, and depression.* Significant difference between below and above average income groups within country at p<.05.Source: Commonwealth Fund 2004 International Health Policy Survey.

7

25

3

14

24

5

24

3

12 13

0

25

50

75


Zealand

United

Kingdom

United

States


Figure 6. Access to Doctor When Sick orNeed Medical Attention, by Income

Percent waited six days or more for appointment when sick

* Significant difference between below and above average income groups within country at p<.05.Source: Commonwealth Fund 2004 International Health Policy Survey

*

12

21

6 6

19

914

6 511

0

25

50

75


Zealand

United

Kingdom

United

States


Figure 7. ER Visit for Condition a Primary CareDoctor Could Have Treated if Available, by Income

Percent

Source: Commonwealth Fund 2004 International Health Policy Survey.

Figure 8. Difficulty Getting Care on Nights, Weekends, Holidays Without Going to ER

Percent saying “very” or “somewhat difficult”

5360

3242

70

56 59

3244

60

0

25

50

75

100


Zealand

United

Kingdom

United

States



*

3526

44

12

57

25

6

29

12

24

0

25

50

75


Zealand

United

Kingdom

United

States


Figure 9. Cost-Related Access Problems, by Income

Percent reporting any of three access problems because of costs^

^ Access problems include: Had a medical problem but did not visit a doctor; skipped a medical test, treatment, or follow-up recommended by a doctor; or did not fill a prescription because of cost.* Significant difference between below and above average income groups within country at p<.05.Source: Commonwealth Fund 2004 International Health Policy Survey.

*

*

*

*

*

Figure 10. Care Coordination, by Income

26 29 27 26

3628 25 23 24 27

0

25

50

75


Zealand

United

Kingdom

United

States


^ Coordination problems include: Test results or medical records not available at time of appointment, received conflicting information from different doctors, or doctor ordered duplicate medical test.* Significant difference between below and above average income groups within country at p<.05.Source: Commonwealth Fund 2004 International Health Policy Survey.

Percent reporting any of three care coordination problems^

Base: Have seen a doctor in past two years

*

Figure 11. Did Not Receive Test Resultsor Results Not Clearly Explained, by Income

1928

23 23 25

11

3024

20 17

0

25

50

75


Zealand

United

Kingdom

United

States



Base: Adults with test in past two yearsPercent

**

Figure 12. Percent of Patients Whose DoctorHas Not Reviewed All Medications, by Income

27 25 2838

2935

2332 35

21

0

25

50

75


Zealand

United

Kingdom

United

States



Base: Adults taking prescriptions regularly

Percent

9 11 9 12

22

7 84

117

0

25

50

75


Zealand

United

Kingdom

United

States


Percent


Figure 13. Rated Doctor Fair or Poor, by Income

*

*

Figure 14. Had Blood Pressure Check in Past Year,by Income

85

72777983

91

6170

8279

0

25

50

75

100


Zealand

United

Kingdom

United

States

Below average income Above average incomePercent

**

*


Figure 15. Had Pap Test in Past Three Years,by Income

8673716975

84 84 84 8293

0

25

50

75

100


Zealand

United

Kingdom

United

States


Base: Women ages 25–64

* Significant difference between below and above average income groups within country at p<.05.Source: Commonwealth Fund 2004 International Health Policy Survey

Percent

* * * **

Figure 16. Under 65: ER Use—Comparisons with U.S. Insured and Uninsured

29

39

2630

3427

46

0

25

50

75


Percent under 65 with ER visit in past two years

United States


**

Figure 17. Under 65: Coordination Problem— Comparisons with U.S. Insured and Uninsured

3026 26 26

3328

44

0

25

50

75


Percent under 65 with at least one of three coordination problems^

United States

^ Coordination problems include: Test results or medical records not available at time of appointment, received conflicting information from different doctors, or doctor ordered duplicate medical test.* Significantly different from U.S. insured at p<.05.Uninsured = uninsured at time of survey or any time during the year.Source: Commonwealth Fund 2004 International Health Policy Survey.

*

Figure 18. Under 65: Lab Test Errors—Comparisons with U.S. Insured and Uninsured

9 12 159

16 13

27

0

25

50

75


Percent given wrong result or delay in receiving abnormal test result

United States

Base: Under 65 who have had lab tests in past two years

* *

*


Figure 19. Health Care Experiences by Incomeand Insurance: U.S. Adults Ages 19–64

27

27

23

76

6

10

8

22

14

15

7

44

0 25 50 75 100

Uninsured

Insured: Below average income

Insured: Above average income

* Significantly different from insured below average income group at p<.05.Uninsured = uninsured at time of survey or any time during the year.Source: Commonwealth Fund 2004 International Health Policy Survey.

Rated doctorfair/poor

Lab error

Access problembecause of cost

Duplicationof tests

*

*

*

*

*

*

General access

(4)

Access becauseof cost

(4)Coordination

(9)

Doctor–Patient

(8)Prevention

(5)Total(30)

AUS 0 0 0 0 1 1

CAN 2 0 3 0 1 6

NZ 0 0 1 1 0 2

UK 0 0 2 1 3 6

US 2 4 3 7 0 16


Figure 20. Ranking of Below Average Income Adults’ Experiences by Country

Number of Measures Where Below Average Income Adults’ Experiences in Country Was the Worst Compared with

Below Average Income Adults in the Other Four Countries

* Inequity counted when significant difference between income groupswhere p .05 and gap of >5%; for U.S. p<.05 and gap>5%, or gap>5%.

Generalaccess

(4)

Accessbecauseof cost

(4)Coordination

(9)

Doctor–Patient

(8)Prevention

(5)Total(30)

AUS 0 3 1 0 0 4

CAN 0 4 1 0 0 5

NZ 0 4 1 3 0 8

UK 0 1 0 0 0 1

US 3 4 5 7 2 21


Figure 21. Inequity Summary:Number of Measures Where Below Average Income Adults

Have More Negative Experiences

Figure ES-1. Difficulty Getting Care on Nights, Weekends, Holidays Without Going to ER Percent...

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