Commonwealth Fund findings on "sicker" adults released

The annual Commonwealth Fund International Health Policy surveys track trends in health care access, affordability, quality and general policy and practices issues internationally.

This week,  the Commonwealth Fund released its findings from the 2011 survey with a focus on the United States’ health care system. The 2011 survey looked at health care experiences of adults who are likely to have greater health care needs (so-called “sicker” adults).

The Health Council of Canada, a co-founder of this survey, has used the same data to understand Canadian health care system performance from the views of ‘sicker’ adults in the 11 participating countries. In our analysis, sicker Canadians are those with chronic conditions who describe their health as poor or fair. Our analysis highlights the gaps in our health care system for this population of sicker Canadians who have greater health care needs in access, affordability, timeliness, coordination and patient engagement.

Access

• Of the countries surveyed, Canadians (36%) rank high in finding it very difficult to access care in the evenings, weekends and holidays, without going to an emergency department.
• Canadians (60%) are the most likely to use the emergency department when compared internationally (47%). As a result Canadians are also among the highest users of emergency departments for conditions that could be treated at their regular place of care if it had been available.

Affordability

• Canadians rank second highest (following the US) in reporting concerns about prescription costs. Nearly one-quarter of sicker Canadians report not filling a prescription for medicine, or skipping doses because of cost.

Timeliness

• Overall, Canadians have the longest waits to get an appointment. Only half of Canadians (50%) say can get an appointment on the same or next day when they’re sick or need medical attention. Canadians also have long waits to see a specialist compared to international respondents. Half of Canadians (50%) say they have had to wait four or more weeks to see a specialist after being advised to do so.

Coordination

·         Canadians have the most difficulty in having their test results or medical records available at appointments. Nearly one-quarter say their test results or medical records were not available at the time of their appointment.  However, Canadians rank above international average in receiving help from their regular doctor to coordinate other care.

Patient engagement

·         Sicker Canadians (55%) are among the those least likely to report they have enough time with their doctor, a key barrier to patient engagement. However, these same Canadians have similar ratings to the international average in understanding information from their regular doctor and feeling encouraged to ask questions. 

For more detailed findings on these key areas of health system performance, please download our findings chart pack with a comparison of sicker Canadians internationally.

In December, we will release a report that focuses on the health care experiences of sicker Canadians’ compared to that of the general public. The report highlights what is working and isn’t working in Canada as it pertains to Canadians with greater health care needs.

Sukirtha Tharmalingam, Senior Policy Analyst, Health Council of Canada

Key Words: Access and Wait Times, Primary Health Care