Germany, Britain, Australia, and Canada all provide better care for less money, the Commonwealth Fund report found.
"The U.S. healthcare system ranks last compared with five other nations on measures of quality, access, efficiency, equity, and outcomes," the nonprofit group which studies healthcare issues said in a statement.
Canada rates second worst out of the five overall. Germany scored highest, followed by Britain, Australia, and New Zealand.
"The United States is not getting value for the money that is spent on healthcare," Commonwealth Fund president Karen Davis said in a telephone interview.
The group has consistently found that the U.S., the only one of the six nations that does not provide universal healthcare, scores more poorly than the others on many measures of healthcare.
Congress, President George W. Bush, many employers, and insurers have all agreed in recent months to overhaul the U.S. healthcare system -- an uncoordinated conglomeration of employer-funded care, private health insurance, and government programs.
The current system leaves about 45 million people with no insurance at all, according to U.S. government estimates from 2005, and many studies have shown most of these people do not receive preventive services that not only keep them healthier, but reduce long-term costs.
Davis said the fund's researchers looked at hard data for the report.
"It is pretty indisputable that we spend twice what other countries spend on average," she said.
Per capita health spending in the U.S. in 2004 was $6,102, twice that of Germany, which spent $3,005. Canada spent $3,165, New Zealand $2,083, and Australia $2,876, while Britain spent $2,546 per person.
"We focus primarily on measures that are sensitive to medical care making a difference -- infant mortality and healthy lives at age 60," Davis said. "Those are pretty key measures, like how long you live and whether you are going to die before age 75."
Measures of other aspects of care, such as cataract surgery or hip replacement, are harder to come by, she said.
They also looked at convenience and again found the U.S. lacking -- with a few exceptions.
"We include measures such as waiting more than four months for elective, nonemergency surgery. The United States doesn't do as well as Germany but it does a lot better than the other countries on waiting time for surgery," Davis said.
"We looked at the time it takes to get in to see your own doctor ... (or) once you go to the emergency room do you sit there for more than two hours, and truthfully, we don't do well on those measures," Davis said.
According to the report, 61% of U.S. patients said it was somewhat or very difficult to get care on nights or weekends, compared with 25% to 59% in other countries.
"The area where the U.S. healthcare system performs best is preventive care, an area that has been monitored closely for over a decade by managed care plans," the report reads.
The U.S. had the fewest patients -- 84% -- reporting that they have a regular doctor.
And U.S. doctors are the least wired, with the lowest percentage using electronic medical records or receiving electronic updates on recommended treatments.
By Maggie Fox
Last Updated: 2007-05-15 11:10:15 -0400 (Reuters Health)
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