In chronic condition: experiences of patients with complex health care needs, in eight countries, 2008

Health Aff (Millwood). 2009 Jan-Feb;28(1):w1-16. doi: 10.1377/hlthaff.28.1.w1. Epub 2008 Nov 13.


This 2008 survey of chronically ill adults in Australia, Canada, France, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States finds major differences among countries in access, safety, and care efficiency. U.S. patients were at particularly high risk of forgoing care because of costs and of experiencing inefficient, poorly organized care, or errors. The Dutch, who have a strong primary care infrastructure, report notably positive access and coordination experiences. Still, deficits in care management during hospital discharge or when seeing multiple doctors occurred in all countries. Findings highlight the need for system innovations to improve outcomes for patients with complex chronic conditions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Chronic Disease / therapy
  • Developed Countries*
  • Health Care Surveys
  • Health Services Needs and Demand*
  • Humans
  • Middle Aged
  • Patient Satisfaction*
  • Severity of Illness Index