The Commonwealth Fund released a study on November 9 based on surveys of 18,000 adults aged 18 or older in fair or poor health in eleven countries demonstrating that, in every country, persons with complex health needs who receive care through a medical home (an accessible primary care practice that knows their medical history and helps coordinate their care) report substantially fewer medical errors and duplication of diagnostic tests, better arrangements for follow-up care after a hospitalization, better relationships with their physicians, and greater satisfaction with their care. The United Kingdom was first among the eleven countries with the highest percentage of survey participants with a medical home (74 percent), the lowest percentage (20 percent) of survey participants who had experienced coordination gaps in the previous two years (test results not available at the time of appointment, doctors ordering tests that had already been done, providers failing to share important information with each other, specialists not having information about medical history, and/or regular doctors not informed about specialist care), the lowest percentage (26 percent) of survey participants who experienced problems following hospital discharges (patients not receiving instructions about symptoms and when to seek further care, not knowing who to contact for questions, not receiving a written plan of care after discharge, not having arrangements made for follow-up visits, and/or not receiving clear instructions about medications), and the lowest percentage (16 percent) of survey participants for whom prescriptions were not reviewed or discussed in the past year. The United States was fourth among the eleven countries in the percentage of survey participants with a medical home (56 percent) and eighth, second, and fourth respectively in the care coordination performance measures in which the U.K. was first. The other countries included in the study were Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, and Switzerland.
