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2001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
The 2001 Commonwealth Fund International Health Policy Survey
Accompanies May/June 2002 Health Affairs article
Charts Originally Presented at the 2001 International Symposium on Health Care Policy Charts
22001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
2001 International Health Policy Survey
• Topics: System Views; Access, Quality and Cost; Worries About the Future -- By Income and Trends
• Survey of 1,400 adults in each of five countries, Australia, Canada, New Zealand, United Kingdom and United States
• Conducted by Harris Interactive and subcontractors from April 23, 2001 to May 31, 2001.
• Low income defined as adults reporting incomes “below” or “much below” average (median) national income.
• Margin of error + or - 3 percentage points for differences between countries and + or - 2% for country averages
32001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Views of Health Care System in Five Nations - 1988-2001
Rebuild CompletelyOnly Minor Changes
Needed
1988* 1998** 2001 1988* 1998** 2001
Australia 17 30 19 34 19 25
Canada 5 23 18 56 20 21
New Zealand x 32 20 x 9 18
United Kingdom 17 14 18 27 25 21
United States 29 33 28 10 17 18
x 1988 data not available.*Harvard/Harris/Baxter, 1988. **1998 Commonwealth Fund International Health Policy Survey.
42001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Income and Health: Percent Reporting Fair or Poor Health
30%
23% 23%
31%37%
10% 9% 10% 10% 9%
0%
25%
50%
AUS CAN NZ UK US
Below average income Above average income
52001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Percent Who Believe that Adults with Low Incomes Have More Problems Getting Care
than Those with Higher Incomes
81%
65%
87%
70%80%81%
73%
59%
78%84%
0%
50%
100%
AUS CAN NZ UK US
Below average income Above average incomePercent
2001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Access
72001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Views of Change in Own and Family’s Access to Care 2001
19%
26%
15% 17%20%
8% 6%10% 11%
17%
0%
25%
50%
AUS CAN NZ UK US
Gotten worse over past 2 years
Gotten better over past 2 years
Percent
82001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Difficulties Getting Care, 2001
Percent of adults reporting:
AUS CAN NZ UK US
Very or somewhat difficult to get care in evening or on weekends
34 41 23 33 41
Often or sometimes unable to get care because it is not available where you live
17 21 18 13 20
Extremely/very difficult to see a specialist when needed
12 16 11 13 17
92001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Same Day Access to Doctors
62%
35%
69%
42%36%
0%
40%
80%
AUS CAN NZ UK US
Percent of patients able to get same day appointment when sick
102001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Extremely or Very Difficult to See A Specialist When Needed, by Income
14%20% 21%
16%
30%
11%14%
6%9% 8%
0%
25%
50%
AUS CAN NZ UK US
Below average income Above average income
Percent
112001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Had Access Problems in Past Year Due to Cost
Percent in the past year who:
AUS CAN NZ UK US
Did not fill a prescription due to cost
19 13 15 7 26
Had a medical problem but did not visit doctor due to cost
11 5 20 3 24
Did not get test, treatment or follow-up due to cost 15 6 14 2 22
Needed dental care but did not see a dentist due to cost
33 26 37 19 35
122001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Did Not Get a Recommended Test, Treatment or Follow-up Due to Cost, by
Income
17%
9%
18%
4%
36%
14%
4%
11%
2%
14%
0%
25%
50%
AUS CAN NZ UK US
Below average income Above average income
Percent
132001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Did Not Get Needed Dental Care Due to Cost, by Income
38%42% 40%
20%
51%
15%
24%31%
36%
19%
0%
30%
60%
AUS CAN NZ UK US
Below average income Above average incomePercent
2001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Quality
152001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Waited Less Than One Month for Elective or Non-Emergency Surgery
46%
28% 26% 23%
60%51%
37%43%
38%
63%
0%
50%
100%
AUS CAN NZ UK US
1998 2001
Base: Those with elective surgery in the past 2 yearsPercent
1998 Commonwealth Fund International Health Policy Survey and
162001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Waited Four Months or More for Elective or Non-Emergency Surgery
17%12%
22%33%
1%
23% 27% 26%
38%
5%
0%
50%
100%
AUS CAN NZ UK US
1998 2001
Base: Those with elective surgery in the past 2 years
Percent
1998 Commonwealth Fund International Health Policy Survey and
172001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Hospital Care Quality Concerns, 2001
Percent of those hospitalized who:
AUS CAN NZ UK US
Rated overall hospital experience fair or poor
18 19 20 22 20
Rated availability of nurses as fair or poor 24 22 22 28 22
Base: Hospitalized in Past Two Years
182001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Received Conflicting Information fromDifferent Health Professionals When Sick
31% 33%29% 31%
44%
0%
25%
50%
75%
AUS CAN NZ UK US
Percent “often” or “sometimes” received conflicting information
Base: Adults with a serious illness, injury, or disability in past 2 years
192001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Physician Ratings
Percent rating physician as excellent or very good on:
AUS CAN NZ UK US
Treating you with dignity and respect
80 79 84 73 72
Listening carefully to your health concerns
73 74 75 67 65
Providing all the information you want
72 67 73 58 63
Spending enough time69 62 71 54 58
Knowing you and your family situation 63 59 67 51 57
Being accessible by phone or in person 59 55 64 48 52
202001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Composite Physician Ratings
69% 66%72%
59% 61%
0%
50%
100%
AUS CAN NZ UK US
*Average excellent or very good rating of: treating you with dignity & respect, listening carefully, being accessible by phone or in person, spending enough time, knowing you, and providing you with all the information you want.
Percent rating physicians excellent or very good on six measures of responsiveness
212001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Composite Rating of Physicians, by Income
72% 67% 71%60%
51%
69%
54%
73%69%69%
0%
50%
100%
AUS CAN NZ UK US
Below average income Above average income
Percent rating physicians excellent or very good on six measures*
*Average excellent or very good rating of: treating you with dignity & respect, listening carefully, being accessible by phone or in person, spending enough time, knowing you, and providing you with all the information you want.
222001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Rated Overall Medical Care Received in the Past 12 Months as Excellent or Very Good
53% 54% 54% 50% 50%63%
54%67%
53% 58%
0%
50%
100%
AUS CAN NZ UK US
1998 2001
Percent
1998 Commonwealth Fund International Health Policy Survey and
2001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Costs and Worries About the Future
242001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Out of Pocket Costs for Prescription Drugs
6%
23%19%
26%
8%
16%
40%
7%10%
44%
0%
25%
50%
No out-of-pocket spending
on prescription drugs
More than $200
AUS CAN NZ UK USPercent
252001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Did Not Fill A Prescription Due To Cost In Past Year, 1998 and 2001
12%
7%
15%
6%
17%19%
13%15%
7%
26%
0%
15%
30%
AUS CAN NZ UK US
1998 2001
Percent
1998 Commonwealth Fund International Health Policy Survey and
262001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Did Not Fill a Prescription Due to Cost in Past Year, by Income
21% 22% 20%
7%
39%
18%
7%11%
7%
18%
0%
25%
50%
AUS CAN NZ UK US
Below average income Above average income
Percent
272001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Total Out of Pocket Costs, 2001
4%8%
35%
5%6%11%
43%
2%7%
26%
0%
25%
50%
No out-of-pocket costs More than $1000
AUS CAN NZ UK USPercent
282001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Had Problems Paying Medical Bills In Past Year, 2001
11%7%
12%
3%
21%
0%
20%
40%
AUS CAN NZ UK US
Percent
292001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Had Problems Paying Medical Bills in the Past Year, By Income
17%14%
20%
4%
35%
8%3%
7%2%
11%
0%
20%
40%
AUS CAN NZ UK US
Below average income Above average incomePercent
302001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Worries About the Future
Percent saying “very worried” that:
AUS CAN NZ UK US
Would not be able to get most advanced care if seriously ill
24 23 24 18 22
Would not be able to afford treatment if seriously ill 26 20 24 15 29
Will not be able to pay for long term care for family member
30 26 32 23 35
Will wait too long to get non-emergency care 19 17 20 15 14
312001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Composite of “Very Worried” About Future Ability to Get Care, by Income
29% 30% 30%
20%
37%
18%16%21%
16%22%
0%
25%
50%
AUS CA NZ UK US
Below average income Above average income
*Country averages of percent very worried: they would not be able to get the most advanced care if seriously ill, would not be able to afford treatment if seriously ill, would not be able to pay for long term care or would wait too long for non-emergency care.
Percent they are very worried on a series of measures*
322001Commonwealth Fund International Health Policy SurveyCommonwealth Fund/Harvard/Harris Interactive
Methodology
Surveys of nationally representative, non-institutionalized adult populations in each of the five countries were conducted by telephone during April-May 2001 by Harris Interactive and their international affiliates. Interviews resulted in a sample of 1412 adults in Australia, 1400 in Canada, 1400 in New Zealand, 1400 in the United Kingdom, and 1401 in the United States. Identical instruments were used in all of the countries. The surveys were designed by a team of researchers at the Harvard School of Public Health and the Commonwealth Fund and reviewed by experts in each country.