The Commonwealth Fund: Public Views of the U.S. Health System

This issue brief from The Commonwealth Fund reports on current public opinions about the U.S. health system, based on a representative household telephone survey of adults (ages 18 and older) conducted in February 2011 (n=1,011).  The margin of error is +/- 3%.

Even for those insured, 26% of those surveyed reported difficulties getting same- or next-day appointments with their doctor when they were sick; 38% had difficulties getting advice from their doctor by phone during regular office hours, and 56% said it was difficult to get care on nights, weekends, or holidays without going to the emergency room.  Predictably, these difficulties were more severe for those uninsured: 42% reported difficulties getting appointments when sick and 65% reported difficulties getting care on nights, weekends or holidays without going to the emergency room.

In terms of care coordination, among those respondents who were insured, 17% reported that their doctor ordered a test that had already been done; the rate was 44% for those uninsured.  27% reported that no one called or sent them the results after a medical test. For respondents with three or more doctors, 18% reported that their specialist did not receive basic medical information from their primary doctor while 24% reported that their primary doctor did not receive a report from a specialist following a visit.

13% of the respondents reported that in the past two years, they or their family member ended up with an infection or complication as a result of medical care, and 15% said their health care providers had made a surgical or medical error.

Looking ahead to national health care reform, 93% of the respondents believe it is important to have one place or doctor responsible for primary care and coordinating care. 96% believe it is important that all their doctors have access to their medical records.  96% want information about the quality of care provided by different doctors and hospitals.

However, only 14% currently can access their medical records through the internet, while 34% manage their prescriptions online, 22% can schedule appointments online, and 21% communicate with their doctors online.  Of those who currently do not have online access to their health information or providers, 55% would like to order or refill prescriptions online, 56% would like to be able to schedule appointments online, 57% would like to communicate with their doctors online, and 50% would like to access their medical records online.

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