Some rich countries’ health care systems give the patients a lot more aggravation than others.

Karen Davis and other analysts at the Commonwealth Fund put the story in numbers in the latest report in a series of reports that compare the U.S. health care system with the health care systems in other high-income countries.

The analysts applied quality, access, efficiency and fairness indicators to the health care systems in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom as well as in the United States.

For the new report, the analysts used patient surveys conducted in 2011 and 2013, physician surveys conducted in 2012, and national health data compiled by the World Health Organization.

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The analysts found that the United States spent $8,508 per person on health care, after adjusting for purchasing power parity, in 2011. That compared with adjusted averages ranging from $3,182  — in New Zealand  — to $5,669  — in Norway  — in the rest of the world.

Growth in U.S. health care spending as a share of gross domestic product (GDP) increased much faster than in the other countries from 1980 to 1992, and about the same rate from 1992 to 1998. Growth then jumped for a few years before settling down around 2008.

The United States performed best in the comparisons on indicators of whether health care systems have been providing patient-centered care. The United States came in at fourth on that indicator. The analysts found, for example, that U.S. patients were the ones most likely to report that doctors had encouraged them to exercise and to eat a healthy diet.

The U.S. patients were also the least likely to report having an infection shortly after entering the hospital.

But the United States ranked ninth in terms of the percentage of patients saying a hospital or pharmacy had given them the wrong medication or the wrong dose of a medication.

For a look at a care access indicator  — how likely people with above-average income and below-average income were to say they had skipped going to the doctor when they were sick because of concerns about cost — read on. 

Sheep

7. New Zealand

Percentage who skipped doctor visit when sick because of cost: 

Below-average income: 23 percent.

Above-average income: 15 percent.

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Kangaroo

7. Australia

Percentage who skipped doctor visit when sick because of cost:

Below-average income: 14 percent.

Above-average income: 5 percent. 

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Bergen, Norway

9. Norway

Percentage who skipped doctor visit when sick because of cost:

Below-average income: 7 percent.

Above-average income: 3 percent.

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Toronto

10. Canada

Percentage who skipped doctor visit when sick because of cost:

Below-average income: 7 percent.

Above-average income: 9 percent.

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Statue of Liberty

11. United States

Percentage who skipped doctor visit when sick because of cost:

Below-average income: 39 percent.

Above-average income: 17 percent.

U.S. residents were so likely to skip seeing a doctor when sick because of cost that U.S. residents with above-average income were more likely to stay away from the doctor due to cost than the low-income residents of nine of the other countries included. The only country included in which people with below-average income were more likely to stay away from doctors due to cost than the U.S. residents with above-average income was New Zealand.

The United States performed well on an indicator of access to specialist care but ranked sixth to eighth on most timeliness of care measures. 

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