Chronically ill Americans are more likely to forgo medical care because of high costs or experience medical errors than patients in other affluent countries, according to a study released on Thursday.

The study comparing the experiences of patients in eight nations reflected poorly on the U.S. health care system as President-elect Barack Obama and his allies work on plans to rein in health costs and extend insurance to more people.

The researchers questioned 7,500 adults in Australia, Canada, France, Germany, Netherlands, New Zealand, Britain and the United States. Each had at least one of seven chronic conditions: high blood pressure, heart disease, lung disease, diabetes, cancer, arthritis and depression.

Dutch patients had the fewest complaints, while the Americans had plenty, according to the study by the Commonwealth Fund, a New York-based health policy research group.

Fifty-four percent of Americans surveyed said high costs prevented them at some point from getting recommended medical care, filling prescriptions or seeing a doctor when ill. Seven percent of the Dutch cited cost as a barrier to treatment.

In addition, 41 percent of the U.S. patients said they spent more than $1,000 over the past year on out-of-pocket medical costs. That compared to lows of 4 percent in Britain and 5 percent in France.

A third of U.S. patients said they were given the wrong medication or dosage, experienced a medical error, received incorrect test results or faced delays in hearing about test results, more than any of the other countries.


Almost half of the U.S. patients said their time had been wasted because of poorly organized care or had received care of little or no value during the past two years. These views were lowest in the Netherlands and Britain.

Only Canadians reported visiting an emergency room at higher rates in the past two years than the Americans.

The Commonwealth Fund's Cathy Schoen, who worked on the study, said the United States spends twice as much on health care as the others, with the current economic woes putting more people at risk of losing employer-provided health insurance.

"Overall, the United States stands out for chronically ill adults reporting the most negative experiences," Schoen said in a conference call with reporters.

"In short, the U.S. patients are telling us about inefficient, unsafe and often wasteful care. The lack of access, combined with poorly coordinated care, is putting these patients at very high health risk and driving up costs of care."

The U.S. Census Bureau has reported that 15 percent of Americans, 45.7 million people, had no public or private health insurance last year.

The study, published in the journal Health Affairs, was the latest to show the U.S. health care system is performing worse than those in comparable countries. Unlike many rich nations, the United States does not have universal health care.