The U.S. health care divide: disparities in primary care experiences by income : findings from the Commonwealth Fund 2004 International Health Policy Survey
In analyzing findings from the Commonwealth Fund 2004 International Health Policy Survey, which studied adults in the United States, the United Kingdom, Australia, Canada, and New Zealand, this report finds a wide health care divide by income. There is health care gap not only separating the U.S. from the other four countries, but also one standing between lower-income and higher-income Americans. Among the countries surveyed, the U.S. stands out for income-based disparities in patient experiences, with below-average-income U.S. adults reporting the worst experiences--compared with their counterparts in the other four countries--on most measures of primary care access, coordination, and doctor-patient relationships. Although a lack of health insurance intensified the disparities, with uninsured U.S. adults often forgoing needed care, insurance coverage does not level the playing field. Even when insured, below-average-income Americans under the age of 65 were more likely to report access problems and delays than insured, above-average-income adults.
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