United States has highest rate of poor primary care coordination among 11 high-income countries

Care coordination has been identified as a key strategy for improving the effectiveness, safety and efficiency of the U.S. health care system. In new research published in the March/April issue of Annals of Family Medicine, researchers examine care coordination in 11 high-income countries and find one out of every three respondents experienced at least one coordination gap in primary care, but the overall percentage reporting poor primary care coordination was low. Notably, among the 11 countries evaluated, the United States had the highest rate of poor primary care coordination.

Analyzing 2013 Commonwealth Fund survey data from 13,958 patients from Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States, researchers found the rate of poor primary care coordination was 5 percent overall and highest in the United States at 10 percent. Patients were less likely to experience poor care coordination if their primary care physician knew them well, spent sufficient time with them, involved them in care, and explained things well. Poor primary care coordination was more likely to occur among patients with chronic conditions and patients younger than 65 years.

Notably, in the United States, patients reported similar levels of poor primary care coordination regardless of insurance status, health status, income level and sex, suggesting a systemic issue in the U.S. health care system that distinguishes its efficacy of primary care coordination from that of other countries.

The authors note that care coordination gaps have been associated with a higher risk of patients experiencing a medical error, more follow-up appointments, and unnecessary health care spending. They conclude these findings warrant increased efforts to support relationships between primary care providers and patients, especially those who are younger and chronically ill.