NCPA - National Center for Policy Analysis


November 3, 2006

Americans have a harder time than residents of several other countries getting after-hours appointments with a nurse or primary care physician without going to an emergency room, according to a study published in the journal Health Affairs.

Other findings:

  • Forty percent of U.S. primary care doctors said they had arrangements for after-hours care, according to the survey of more than 6,000 physicians in seven countries.
  • That compared with 95 percent in the Netherlands, 90 percent in New Zealand, 87 percent in the United Kingdom, 76 percent in Germany and 47 percent in Canada.


  • The United States trails other countries in adopting electronic medical records and computerized systems to remind patients about follow-up care, prompt physicians to give patients test results and warn of potentially harmful drug interactions.  
  • Primary care doctors in America were also less likely to have financial incentives to improve the quality of the care they provide.

Advocates say greater use of electronic records would improve patient care, reduce errors, curb unnecessary tests and cut paperwork.  About 28 percent of U.S. primary care doctors said they use such records, compared with 98 percent in the Netherlands, 92 percent in New Zealand, 89 percent in the United Kingdom, 79 percent in Australia and 42 percent in Germany. Only Canada ranked lower, at 23 percent.

Source: Christopher Lee, "U.S. Lags in Several Areas of Health Care, Study Finds," Washington Post, November 3, 2006; based upon: Cathy Schoen et al., "On The Front Lines Of Care: Primary Care Doctors' Office Systems, Experiences, And Views In Seven Countries," Health Affairs, November 2, 2006.

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