Elderly still lag in many healthcare metrics

Despite the universal healthcare coverage Medicare provides, America’s elderly still lag on many-but by no means all-measures of health and care access compared with other industrialized nations, a new survey finds.

The survey of adults age 65 and older in the United States and 10 other nations finds that Americans are:

• the most likely (87%) to have a chronic condition,

• the most likely (19%) to have cost-related problems in obtaining medical care

• the most likely (23%) to report that their medical records and/or test results were not available at a scheduled appointment or that tests were duplicated, and

• the most likely, along with Canadians (39%) to have obtained care in an emergency department during the past two years.

The authors of the 2014 Commonwealth Fund International Health Policy Survey of Older Adults note that while Medicare offers better coverage than most other health insurance in the United States, “it is still clearly less protective than the universal coverage offered in the health systems of other countries surveyed.”

Its shortcomings, they say, most likely reflect “limitations in Medicare coverage, including substantial deductibles and copayments, especially for pharmaceuticals, which are often more expensive in the United States than elsewhere.” Lack of limitations on catastrophic expenses and long-term care coverage also play a role, they add.

Next: Where the United States fares well

The survey also included categories in which the United States fares well. Among categories in which America ranks at or near the top:

• Wait times of four weeks or less to see a specialist (86% of respondents).

• Having a treatment plan for their condition that they could carry out in their daily life (83%).

• Having a healthcare professional whom they could easily contact with questions or for advice (84%).

• Having a discussion with someone regarding healthcare treatment they want if they become very ill and can’t make decisions for themselves (78%).

In addition, America had the lowest percentage of respondents reporting that a healthcare professional had not reviewed their prescription medications in the past year (14%) or experienced gaps in their hospital discharge planning in the previous two years (28%.)

The authors note that none of the 11 nations surveyed-Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States-are able to offer their older adults accessible, coordinated, and patient-centered care on a consistent basis.

Nevertheless, the fact that elderly U.S. residents are sicker than the elderly in comparable nations “will pose critical challenges for U.S. policymakers in years to come,” the authors write, especially in light of the facts that the U.S. already spends significantly on healthcare than all the other countries in the survey, despite having a younger population. 

Results of the survey were published online first in November on the Health Affairs website in an article titled “International Survey of Older Adults Finds Shortcomings In Access, Coordination, and Patient-Centered Care.”