The survey found wide variations in access, coordination, and patient-reported medical errors.

• Despite having very different health care systems, the U.K. and Switzerland were leaders in having rapid access to primary care, easy access to after-hours care and comparatively low rates of coordination gaps and patient-reported medical errors.
• More than seven of 10 patients in the U.K., Switzerland, France, New Zealand and the Netherlands were able to get same- or next-day appointments when they were sick. In contrast, only half of patients in Sweden and Canada reported such rapid access to care.
• One-third or more of sicker adults in all 11 countries had visited an emergency department in the past two years. Emergency department use was highest in Canada, Sweden, the U.S., Australia and New Zealand.
• More than half of German (56 percent) and French (53 percent) patients and more than two of five Norwegian (43 percent) and U.S. (42 percent) patients reported gaps in care coordination, including duplicate tests being ordered, medical records or test results not being available during a medical appointment, or providers not sharing important information with each other. In contrast, only 20 percent of U.K. patients and 23 percent of Swiss patients reported such care gaps.
• The proportion of patients reporting medical errors (including prescription and lab test errors) ranged from a low of 8 percent to 9 percent in the U.K. and Switzerland to 22 percent or more in New Zealand, Norway, and the U.S.

Overall, the survey found that countries are facing similar challenges in providing effective treatment to sicker adults. Evident in every country surveyed were gaps in care coordination, gaps in transitions between hospitals and other community-based care settings, lapses in communication between specialists and primary care physicians, failure to review medications and delays in receiving test results.

The authors point to opportunities for learning as each country implements reforms aimed at improving care outcomes and resource use, including reforms to payment and information systems and the redesign of health care delivery to support team-based care.

“All the other study countries already spend far less than the United States, yet provide more comprehensive, protective benefits,” the study’s authors note. “Comparative research finds the higher costs in the United States are largely due to paying higher prices and not related to the generosity of insurance.”