THE COMMONWEALTH FUND Cost-Related Access Problems Among the Chronically Ill, in Eight Countries, 2008 Base: Adults with any chronic condition Percent reported access problem due to cost in past two years* * Due to cost, respondent did NOT: fill Rx or skipped doses, visit a doctor when had a medical problem, and/or get recommended test, treatment, or follow-up. Data: The Commonwealth Fund International Health Policy Survey of Sicker Adults (2008). Source: C. Schoen et al., “In Chronic Condition: Experiences of Patients with Complex Healthcare Needs in Eight Countries, 2008,” Health Affairs Web Exclusive, Nov. 13, 2008.

THE COMMONWEALTH FUND Access to Doctor When Sick or Needed Care Same-day appointment6+ days wait or never able to get appointment Data collection: Harris Interactive, Inc. Source: 2008 Commonwealth Fund International Health Policy Survey of Sicker Adults. Base: Adults with any chronic condition Percent

THE COMMONWEALTH FUND Difficulty Getting Care After Hours Without Going to the Emergency Room Base: Adults with any chronic condition who needed after-hours care Percent reported very/somewhat difficult getting care on nights, weekends, or holidays without going to ER Data collection: Harris Interactive, Inc. Source: 2008 Commonwealth Fund International Health Policy Survey of Sicker Adults

THE COMMONWEALTH FUND Gaps in Hospital Discharge Planning and Transitional Care Percent did NOTAUSCANFRGERNETHNZUKUS Know who to contact for questions about condition or treatment Receive instructions about symptoms and when to seek further care Receive written plan for care after discharge Have arrangements made for follow-up visits with any doctor Any discharge gaps Data collection: Harris Interactive, Inc. Source: 2008 Commonwealth Fund International Health Policy Survey of Sicker Adults. Base: Adults with any chronic condition who were hospitalized in past 2 years

THE COMMONWEALTH FUND Average Annual Number of Physician Visits per Capita, 2006 *2005 **2004 Data: OECD Health Data 2008 (June 2008).

Cost-Related Access Problems Percent in past year due to cost: AUSCANGERNETHNZUKUS Did not fill prescription or skipped doses Had a medical problem but did not visit doctor Skipped test, treatment, or follow- up Percent who said yes to at least one of the above Source: 2007 Commonwealth Fund International Health Policy Survey. Data collection: Harris Interactive, Inc.

Difficulty Getting Care on Nights, Weekends, Holidays Without Going to the Emergency Room Percent reported very or somewhat difficult Source: 2007 Commonwealth Fund International Health Policy Survey. Data collection: Harris Interactive, Inc.

Communication with Doctor and Electronic Access to Medical Records Base: Have regular doctor/place Percent:AUSCANGERNETHNZUKUS Currently can doctor No Would like to be able to communicate by Have electronic access to medical records No current access: would like electronic access to medical records Source: 2007 Commonwealth Fund International Health Policy Survey. Data collection: Harris Interactive, Inc.

Americans Spend More Out-of-Pocket on Health Care Expenses a 2003 b 2003 Total Health Care Spending, 2002 OOP Spending b a United States OECD Median New Zealand Netherlands Japan Germany France Canada Australia a Source: The Commonwealth Fund, calculated from OECD Health Data Total health care spending per capita Out-of-pocket spending per capita

Mirror, Mirror: Ranking of Six Nations AUSTRALIACANADAGERMANY NEW ZEALAND UNITED KINGDOM UNITED STATES OVERALL RANKING (2007) Quality Care Right Care Safe Care Coordinated Care Patient-Centered Care Access Efficiency Equity Long, Healthy, and Productive Lives Health Expenditures per Capita, 2004$2,876*$3,165$3,005*$2,083$2,546$6,102 Source: K. Davis, C. Schoen, S. C. Schoenbaum, M. M. Doty, A. L. Holmgren, J. L. Kriss, and K. K. Shea, “ Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care, ” The Commonwealth Fund, May 2007 Country Rankings * 2003 data