Comparing Nations on Timeliness and Coordination of Health Care

Aging populations present major challenges to health care systems around the world. The 2021 Commonwealth Fund International Health Policy Survey, conducted among adults age 65 and older between March and June 2021, provides insights about how well U.S. seniors fare relative to older adults in 10 other high-income countries. (See “About This Survey” below.)

The findings present a mixed picture of U.S. health system performance as the COVID-19 pandemic continues:

• U.S. seniors are more likely than their counterparts in other wealthy countries to experience economic hardship as a result of the pandemic, with Latino/Hispanic and Black seniors most affected. Nearly four in 10 older Latino/Hispanic adults and one in three older Black adults said they used up their savings or lost a job or source of income because of COVID-19, compared to 14 percent of older white adults.
• Despite the near-universal coverage Medicare provides, U.S. older adults have comparatively high out-of-pocket health expenses and are much more likely to forgo care because of cost than are their counterparts in the other survey countries.

Overview of Survey Findings on Timeliness and Coordination of Care

The charts that follow present the international survey’s findings on timeliness and coordination of care: how quickly and easily older adults are able to get care when they need it, including through video or telephone appointments; and how well ongoing care is coordinated for patients with multiple chronic conditions.

Responses show that many older adults, both in the U.S. and other countries, experience problems getting timely health care, including waits of six days or more to see a doctor when sick, difficulty in getting after-hours care without visiting an emergency department, and delays in hearing back from their regular doctor on the same day.

The U.S., however, does comparatively well on coordination of patient care, a set of findings consistent with other studies and with previous Commonwealth Fund surveys of older adults. Older adults in the U.S. were the least likely of those surveyed to experience gaps in hospital discharge planning. Among U.S. respondents with chronic conditions, a majority reported having a treatment plan and being in contact with care providers between office visits.