November 18, 2008, — More than half of Americans with chronic health problems like diabetes, heart disease, cancer and depression skip pills and doctors’ appointments because of their costs, according to a new survey by the nonprofit Commonwealth Fund.

The study, published online last week in the journal Health Affairs, compares 7,500 patients in the United States and seven other countries that provide universal health insurance: Australia, Britain, Canada, France, Germany, the Netherlands and New Zealand.

While 54 percent of chronically ill Americans said they had gone without recommended care because of cost, only 7 to 36 percent of patients in the other countries had skipped care for the same reason, the researchers found.

And 42 percent of patients in the United States said they had spent more than $1,000 in the previous year on out-of-pocket medical costs, compared with 4 percent in Britain and 8 percent in the Netherlands.

Patients in the United States were also more likely to have experienced a medical error, like getting the wrong medication or failing to receive prompt notice of an abnormal test result, and they were more likely to suffer from a lack of coordination in their care.

November 18, 2008