title: Primary care and health system performance: adults' experiences in five countries.
abstract: This paper reports on a 2004 survey of primary care experiences among adults in Australia, Canada, New Zealand, the United Kingdom, and the United States. The survey finds shortfalls in delivery of safe, effective, timely, or patient-centered care, with variations among countries. Delays in lab test results and test errors raise safety concerns. Failures to communicate, to engage patients, or to promote health are widespread. Aside from clinical preventive care, the United States performs poorly on most care dimensions in the study, with notable cost-related access concerns and short-term physician relationships. Contrasts across countries point to the potential to improve performance and to learn from international initiatives.
authors.affiliation: Health Policy, Research, and Evaluation, Commonwealth Fund, New York City, USA. CS@cmwf.org
authors.forename: Cathy
authors.initials: C
authors.lastname: Schoen
authors.forename: Robin
authors.initials: R
authors.lastname: Osborn
authors.forename: Phuong Trang
authors.initials: PT
authors.lastname: Huynh
authors.forename: Michelle
authors.initials: M
authors.lastname: Doty
authors.forename: Karen
authors.initials: K
authors.lastname: Davis
authors.forename: Kinga
authors.initials: K
authors.lastname: Zapert
authors.forename: Jordon
authors.initials: J
authors.lastname: Peugh
mesh_terms: D000293:Adolescent; D000328:Adult; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration*; D019049:Developed Countries; D017598:Efficiency, Organizational; D005260:Female; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000706:statistics & numerical data*