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11. Designing a High-Performing Health Care System for Patients with Complex Needs: Ten Recommendations for Policymakers

Publication Date:
09-2017
Content Type:
Special Report
Institution:
Commonwealth Fund
Abstract:
Health care costs are heavily concentrated among people with multiple health problems. Often, these are older adults living with frailty, advanced illness, or other complex conditions. In 2014, the New York–based Commonwealth Fund, a private, independent foundation, established the International Experts Working Group on Patients with Complex Needs through a grant to the London School of Economics and Political Science. The group’s purpose was to outline the prerequisites of a high-performing health care system for “high-need, high-cost” patients and to identify promising international innovations in health care delivery for meeting needs of these patients. Drawing on international experience, quantitative and qualitative evidence, and its members’ collective expertise in policy and program design, implementation, and evaluation, the international working group sought to articulate the principles that underpin high performance for this complex population in health systems around the world.
Topic:
Health and Health Care Policy
Political Geography:
United States and Global Focus

12. Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities fo

Author:
Michelle M. Doty, Arnav Shah, David Squires, Dana O. Sarnak, and Eric C. Schneider
Publication Date:
07-2017
Content Type:
Special Report
Institution:
Commonwealth Fund
Abstract:
The U.S. ranked last on performance overall, and ranked last or near last on the Access, Administrative Efficiency, Equity, and Health Care Outcomes domains. The top-ranked countries overall were the U.K., Australia, and the Netherlands. Based on a broad range of indicators, the U.S. health system is an outlier, spending far more but falling short of the performance achieved by other high-income countries. The results suggest the U.S. health care system should look at other countries’ approaches if it wants to achieve an affordable high-performing health care system that serves all Americans.
Topic:
Health and Health Care Policy
Political Geography:
United States and Global Focus

13. International Profiles of Health Care Systems

Author:
Elias Mossialos, Ana Djordjevic, Robin Osborn, and Dana O. Sarnak
Publication Date:
05-2017
Content Type:
Special Report
Institution:
Commonwealth Fund
Abstract:
This publication presents overviews of the health care systems of Australia, Canada, China, Denmark, England, France, Germany, India, Israel, Italy, Japan, the Netherlands, New Zealand, Norway, Singapore, Sweden, Switzerland, Taiwan, and the United States. Each overview covers health insurance, public and private financing, health system organization and governance, health care quality and coordination, disparities, efficiency and integration, use of information technology and evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views.
Topic:
Health and Health Care Policy
Political Geography:
United States and Global Focus

14. How High-Need Patients Experience the Health Care System in Nine Countries

Author:
Dana O. Sarnak and Jamie Ryan
Publication Date:
01-2016
Content Type:
Special Report
Institution:
Commonwealth Fund
Abstract:
U.S. health care costs are disproportionately concentrated among older adults with multiple chronic conditions or functional limitations—a population often referred to as “high-need” patients. This analysis uses data from the Commonwealth Fund 2014 International Health Policy Survey of Older Adults to investigate health care use, quality, and experiences among high-need patients in nine countries compared with other older adults. High-need patients use a greater amount of health care services and also experience more coordination problems and financial barriers to care compared with other older adults. Disparities are particularly pronounced in the United States. The comparative success of other countries, particularly in reducing financial barriers to care, may be a product of policies that specifically target high-need patients. Similarly focusing on these populations in the U.S. and effectively managing their care may improve their health status while reducing overall costs.
Topic:
Health and Health Care Policy
Political Geography:
United States and Global Focus