“Data for this report were derived from several sources. Survey data are drawn from Commonwealth Fund International Health Policy Surveys fielded during 2017, 2019, and 2020. Since 1998, in collaboration with international partners, the Commonwealth Fund has supported these surveys of the public’s and primary care physicians’ experiences of their health care systems.
“Each year, in collaboration with researchers in the 11 countries, a common questionnaire is developed, translated, adapted, and pretested. The 2020 survey was of the general population; the 2017 survey surveyed adults age 65 and older. The 2020 and 2017 surveys examined patients’ views of the health care system, quality of care, care coordination, medical errors, patient–physician communication, wait times, and access problems. The 2019 survey was administered to primary care physicians and examined their experiences providing care to patients, use of information technology, and use of teams to provide care.”
Source: Eric C. Schneider et al., Mirror, Mirror 2021 — Reflecting Poorly: Health Care in the U.S. Compared to Other High-Income Countries (Commonwealth Fund, Aug. 2021). doi.org/10.26099/01dv-h208
“Measure performance scores: For each measure, we converted each country’s result (e.g., the percentage of survey respondents giving a certain response or a mortality rate) to a measure-specific, “normalized” performance score. This score was calculated as the difference between the country result and the 10-country mean, divided by the standard deviation of the results for each measure (see Appendix 3). Normalizing the results based on the standard deviation accounts for differences between measures in the range of variation among country-specific results. A positive performance score indicates the country performs above the group average; a negative score indicates the country performs below the group average. Performance scores in the equity domain were based on the difference between higher-income and lower-income groups, with a wider difference interpreted as a measure of lower equity between the two income strata in each country.
“The normalized scoring approach assumes that results are normally distributed. In 2021, we noted that the U.S. was such a substantial outlier that it was negatively skewing the mean performance, violating the assumption. In 2017, we had included all 11 countries to calculate the mean and standard deviation of each measure. After conducting an outlier analysis (see below), we chose to adjust the calculation of average performance by excluding the U.S., using the other 10 countries as the sample group for calculating the mean performance score and standard deviation. This modification changes a country’s performance scores relative to the mean but does not affect the ranking of countries relative to one another.”
Source: Eric C. Schneider et al., Mirror, Mirror 2021 — Reflecting Poorly: Health Care in the U.S. Compared to Other High-Income Countries (Commonwealth Fund, Aug. 2021). doi.org/10.26099/01dv-h208
Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.
Page last updated August 7, 2022 by Doug McVay, Editor.
