Case Management

Care coordination is an international problem

Case Management Insider, January 5, 2016

In recent years, healthcare officials have been striving to improve care coordination, which can both improve quality and outcomes for patients and lower healthcare costs.

Turns out the U.S. isn’t the only country that struggles with this issue. A recent analysis by the Commonwealth Fund shows that doctors from 10 nations report that they have a hard time communicating effectively with other providers when dealing with patients with complex care needs.

According to the survey of 11,000 physicians in various countries, 32% of American primary care physicians reported that the emergency department (ED) always notified them when a patient was seen in the hospital and 31% said they were always notified when the patient was discharged. Physicians from other countries reported low rates of notification as well, including the following:

  • In Sweden, 6% were notified of an ED visit and 8% of a discharge
  • In Australia, 18% were notified of an ED visit and 8% of a discharge
  • In Canada, 32% were notified of an ED visit, 29% of a discharge
  • In the United Kingdom, 49% were notified of an ED visit and 37% of a discharge
  • In the Netherlands, 68% were notified of an ED visit and 69% of a discharge

The lowest notification rate was Sweden, the highest in the Netherlands. The survey also uncovered other issues, including the following:

  • 84% of American primary care physicians reported that they weren’t prepared to handle patients with serious mental illness
  • 24% reported that they were not well prepared to treat patient with multiple chronic illnesses
  • 43% coordinated regularly with their patients’ social service providers


“It’s concerning that one in four U.S. primary care doctors don’t think their practices are prepared for the sickest patients, especially when we have so many Americans with multiple chronic illnesses who may get sicker as they age,” said Robin Osborn, lead author of the study and vice president of the International Program in Health Policy and Practice Innovations at The Commonwealth Fund. “To be sure there is affordable, high-quality healthcare for sick and complex patients, we need to continue to strengthen primary care in the U.S.”

An area where the U.S. did shine, however, was in the adoption of electronic medical records, which is up 15% since 2006—and 60% of U.S. patients are able to see an electronic version of their medical record.

Click here to read more about the survey.

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