title: Primary Care Physicians In Ten Countries Report Challenges Caring For Patients With Complex Health Needs.
abstract: Industrialized countries face a daunting challenge in providing high-quality care for aging patients with increasingly complex health care needs who will need ongoing chronic care management, community, and social services in addition to episodic acute care. Our international survey of primary care doctors in the United States and nine other countries reveals their concern about how well prepared their practices are to manage the care of patients with complex needs and about their variable experiences in coordinating care and communicating with specialists, hospitals, home care, and social service providers. While electronic information exchange remains a challenge in most countries, a positive finding was the significant increase in the adoption of electronic health records by primary care doctors in the United States and Canada since 2012. Finally, feedback on job-related stress, perceptions of declining quality of care, and administrative burden signal the need to monitor front-line perspectives as health reforms are conceived and implemented.
authors.affiliation: Robin Osborn (ro@cmwf.org) is vice president of the International Health Policy and Practice Innovations program at the Commonwealth Fund, in New York City.
authors.forename: Robin
authors.initials: R
authors.lastname: Osborn
authors.affiliation: Donald Moulds is executive vice president for programs at the Commonwealth Fund.
authors.forename: Donald
authors.initials: D
authors.lastname: Moulds
authors.affiliation: Eric C. Schneider is senior vice president for policy and research at the Commonwealth Fund.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Schneider
authors.affiliation: Michelle M. Doty is vice president of survey research and evaluation at the Commonwealth Fund.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Doty
authors.affiliation: David Squires is senior researcher to the president at the Commonwealth Fund.
authors.forename: David
authors.initials: D
authors.lastname: Squires
authors.affiliation: Dana O. Sarnak is a research associate in the International Health Policy and Practice Innovations program at the Commonwealth Fund.
authors.forename: Dana O
authors.initials: DO
authors.lastname: Sarnak
mesh_terms: D015897:Comorbidity; D003695:Delivery of Health Care; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D038622:Internationality; D058007:Physicians, Primary Care; D011795:Surveys and Questionnaires; D014481:United States
keywords: Chronic Care; Health Reform; International/global health studies; Organization and Delivery of Care; Physicians