No Recent Improvement in U.S. Healthcare System Performance, Study Finds

Original Source Despite spending more on health care than any other industrialized nation, the United States continues to fall short on key indicators of health outcomes and quality, particularly in the areas of access and efficiency, a new report from the Commonwealth Fund finds. Prepared by the fund’s Commission on a High Performance Health System, the report, Why Not The Best? Results From The National Scorecard on U.S. Health System Performance, 2008 (64 pages, PDF), found that the United States scored an average of 65 out of a possible 100 across thirty-seven key indicators of health outcomes, quality, access, efficiency, and equity – slightly below its overall performance on the 2006 scorecard (36 pages, PDF). Perhaps most troubling, the study found that 42 percent of all working-age adults were either uninsured or underinsured as of 2007 – up from 35 percent in 2003. According to the report, the U.S. could save up to 100,000 lives and $100 billion annually by improving its performance in key areas. On a more positive note, the report found that national initiatives focused on specific areas have yielded substantial improvement. In the wake of broad public and private efforts to assess and improve hospital safety, for example, hospital standardized mortality ratios – a key indicator of patient safety – improved 19 percent over five years. Improvements were also noted in the areas of chronic care and acute hospital care quality, both of which have been the focus of reporting and pay-for-performance initiatives. “We now have 75 million Americans who are uninsured or underinsured,” said lead researcher and Commonwealth Fund senior vice president Cathy Schoen. “Poor access pulls down quality and drives up costs of care. The United States leads the world on healthcare spending – we should expect a far better return on our investment.” Second National Scorecard on U.S. Health Care System Finds No Overall Improvement. Commonwealth Fund Press Release 7/17/08.