P>The U.S. national average score on 37 separate measures of healthcare falls far short when compared either to a few centers of excellence within the country, or to other countries, the report from the Commonwealth Fund found.

"Overall, you will see ... that the United States scores poorly -- an overall score of 66 (out of 100)," Cathy Schoen, senior vice president for research and evaluation at nonprofit healthcare research foundation, told a news conference.

"We have lives at stake both in terms of mortality statistics but also in terms of quality of life."

The scorecard outlines overuse of expensive services, duplication of efforts, failure to coordinate and communicate, and uneven quality of care, even within a single hospital.

Only a quarter of U.S. doctors have computerized their record keeping or writing of prescriptions, with the rest relying on expensive, time-consuming, and mistake-prone paperwork, compared to 80% in some other countries.

The nonprofit fund, whose goal is to improve healthcare, measured 37 indicators ranging from newborn mortality to how much a hospital stay costs for someone with colon cancer.

Overall, the country scored 66 out of a possible 100 on a scale based on the best possible care available within the U.S.

"We can do much better and we need to do much better," said Dr. James Mongan, president of Partners HealthCare System in Boston, told the news conference, although he noted the country is home to some of the world's highest quality healthcare.

First on costs

There is one area where the U.S. comes in first, compared to other countries. "We are by far and away the leader on costs," Schoen said. Americans spend 16% of gross domestic product on health care -- double the median for all industrialized countries.

But the U.S. scores 15th out of 19 developed nations on deaths from causes that are easily prevented if timely medical care is provided, such as heart attacks. France scores the best, with 75 deaths per 100,000, while the U.S. weighs in with 115 per 100,000. Only Ireland, Britain and Portugal score worse.

U.S. infant mortality is far higher than in any of the other 23 countries measured, with a rate of 7 deaths per 1,000 births. The next worst is New Zealand, with 5.6 per 1,000, while Iceland scores the best with 2.2 per 1,000.

Even adults with private health insurance or Medicare do not get lifesaving and money-saving preventive care much of the time, the report found. "Barely half of adults (49%) received preventive and screening tests according to guidelines for their age and sex," the report read.

If people do not want a more equitable healthcare system, they should care about saving money, the Fund experts said.

"If we closed just those gaps that are described in the Scorecard we could save at least $50 billion to $100 billion per year in healthcare spending and prevent 100,000 to 150,000 deaths," the report reads.

"Moreover, the nation would gain from improved productivity."

By Maggie Fox

Last Updated: 2006-09-20 16:27:01 -0400 (Reuters Health)

Related Reading

Revenue cycle review helps imaging centers face challenges to come, August 25, 2006

Copyright © 2006 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.