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Health Aff (Millwood). 2017 Dec;36(12):2123-2132. doi: 10.1377/hlthaff.2017.1048. Epub 2017 Nov 15.

Older Americans Were Sicker And Faced More Financial Barriers To Health Care Than Counterparts In Other Countries.

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Robin Osborn ( ) is vice president of the International Program in Health Policy and Practice Innovations at the Commonwealth Fund, in New York City.
Michelle M. Doty is vice president of survey research and evaluation at the Commonwealth Fund.
Donald Moulds is executive vice president for programs at the Commonwealth Fund.
Dana O. Sarnak is a senior research associate in the International Program in Health Policy and Practice Innovations at the Commonwealth Fund.
Arnav Shah is a research associate for policy and research at the Commonwealth Fund.


High-income countries are grappling with the challenge of caring for aging populations, many of whose members have chronic illnesses and declining capacity to manage activities of daily living. The 2017 Commonwealth Fund International Health Policy Survey of Older Adults in eleven countries showed that US seniors were sicker than their counterparts in other countries and, despite universal coverage under Medicare, faced more financial barriers to health care. The survey's findings also highlight economic hardship and mental health problems that may affect older adults' health, use of care, and outcomes. They show that in some countries, one in five elderly people have unmet needs for social care services-a gap that can undermine health. New to the survey is a focus on the "high-need" elderly (those with multiple chronic conditions or functional limitations), who reported high rates of emergency department use and care coordination failures. Across all eleven countries, many high-need elderly people expressed dissatisfaction with the quality of health care they had received.


Access To Care; Chronic Care; Determinants Of Health; Developed World < International/global health studies; Elderly

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