One patient in four in Germany is in favor of complete reform of the public health system. Most respondents in other nations are more satisfied. A working group around Prof. Peter Sawicki of the Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG) has compared the findings of surveys carried out by the Commonwealth Fund in 2005 and 2008 (Dtsch Arztebl Int 2010; 107[24]: 427-34).
The surveys were carried out simultaneously and using a uniform methodology; in 2008 the participating countries were Australia, Canada, New Zealand, the USA, the United Kingdom, Germany, the Netherlands, and France. Like the survey 3 years before, this 2008 one asked respondents about topics such as patient safety, waiting times, and communication between doctors and patients.
The majority of German patients see public health care as in need of fundamental change, even though 53% rated the quality of their medical care as "good" and 34% as "very good." New Zealanders see themselves as the best cared for: 66% of them checked the "very good" box, and even in the US 55% of respondents did the same.
A particularly noticeable feature of Germany compared to the other countries is the large number of physicians involved in the care of a single patient. Almost half the respondents said that they had seen at least four doctors in the past 2 years. In other countries the figure was at least 10% lower. There were also more complaints in Germany than elsewhere about coordination between specialists and the patient's family doctor.
Similar experiences and problems are apparent in all countries, but public satisfaction with the national health systems varies greatly. The authors believe that this may be a result of differences in expectations and wishes, and is not necessarily a sign of actual differences in quality.
Contact: koch@iqwig.de
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