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Electronic records

Canada’s primary care rated behind other countries

WASHINGTON – Canada scored lower than other countries – except the United States – in an international study of effective primary healthcare for patients released by the Commonwealth Fund.

The survey of more than 6,000 doctors in seven countries gave Canada poor marks on several aspects of patient care, including wait times for tests, use of electronic medical records, doctors available after hours, multi-discipline teams to treat chronic illness and financial incentives for improving quality of care.

The survey suggested Canada has a long way to go on many fronts to catch up with the other countries, which included the United Kingdom, Netherlands, New Zealand, Australia and Germany.

For instance, only 47 percent of Canadian doctors have arrangements for after-hours care so people can avoid going to an emergency room, compared with 95 percent in the Netherlands. Only the United States is lower than Canada at 40 percent.

Other findings include:

• 51 percent of Canadian physicians report patients face long waits for diagnostic tests, compared with 6 percent in Australia.

• Canada’s doctors wait longest for full hospital discharge reports or don’t get them at all.

• Only 23 percent use electronic medical records, the lowest percentage and far behind 98 percent in the Netherlands.

• Most doctors don’t use computers to prescribe medications, access test results and hospital records, receive alerts about potential problems with drug doses or interactions or know when patients are overdue for essential care.

• 32 percent routinely work with multi-discipline teams and non-physicians to treat chronic illnesses, compared with 81 percent in the United Kingdom.

• 41 percent report getting government financial incentives to improve care, compared with 95 percent in the U.K.

• Canada had the lowest rate of doctors giving plans for home care to patients with chronic diseases.

• Only 27 percent of doctors set formal targets for clinical performance, compared with 70 percent in Germany and the U.K. Few collect information on patient satisfaction or clinical outcomes.

A Canadian official acknowledged the country needs to do a lot better in a number of areas, especially wait times and ensuring that doctors have information technology.

“While we are certainly not celebrating the results,” said Frank Fedyk, acting assistant deputy health minister, “we are happy to note that they confirm what we already know, areas where we are, in fact, already taking action.

“We recognize that primary care health renewal involves fundamental changes in the organization and delivery of health services and not simply more of the status quo,” he told a news conference held by the private, non-partisan research group.

“While we are certainly not celebrating the results,” said Frank Fedyk, acting assistant deputy health minister, “we are happy to note that they confirm what we already know, areas where we are, in fact, already taking action.

“We recognize that primary care health renewal involves fundamental changes in the organization and delivery of health services and not simply more of the status quo,” he told a news conference held by the private, non-partisan research group.

 

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