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In a survey of six developed nations, the United States had the dubious distinction of racking up the highest incidence of medical errors. Researchers surveyed sicker adult patients in Australia, Canada, Germany, New Zealand, the United Kingdom, and the United States. Respondents were asked to report whether they experienced one of these four types of medical errors in the previous year: mistake in treatment or care, wrong drug or dose, wrong test results reported, or delays in notification of abnormal test results. The United States had the highest percentage of patients reporting at least one error (34%), followed by Canada (30%), Australia (27%), New Zealand (25%), Germany (23%), and the United Kingdom (22%). In all countries, most of the errors occurred in ambulatory care settings.


Researchers found evidence of poorly coordinated care in all nations regardless of the health care delivery system, but the United States had the highest rate of complaints related to coordination of care. Health care shortcomings were most evident upon hospital discharge (for example, failure to arrange follow-up visits or address post-hospital care) and when patients saw multiple health care providers.


Most patients in Germany, New Zealand, and the United Kingdom reported easy access to after-hours health care. In contrast, most patients in the United States, Australia, and Canada said after-hours access was "very" or "somewhat" difficult. Ease of after-hours access correlated to reduced emergency department use.


Researchers say their findings indicate the need for improved access to health care and better coordination of care, particularly after hospital discharge.




Taking the pulse of health care systems: Experiences of patients with health problems in six countries, C Schoen, et al., Health Affairs Web exclusive, November 3, 2005.