Just 25% of doctors prepared to handle complex patients

One-quarter of U.S. physicians are not prepared to effectively manage and coordinate care for patients with multiple chronic conditions, and 84 percent are not prepared for managing care of patients with severe mental health problems, according to a Commonwealth Fund study published in Health Affairs. 

The report also found that doctors in every country in a 10-country survey reported that, when it comes to managing patients with complex care needs, they struggle to coordinate care and communicate with other healthcare providers.

It's a bigger problem in the U.S. because there are more patients diagnosed with multiple chronic conditions, severe mental illnesses and other significant healthcare challenges.

The 2015 Commonwealth Fund International Health Policy Survey of Primary Care Physicians surveyed more than 11,000 primary care physicians in 10 countries to compare their experiences in providing care to patients with complex problems using health IT and care coordination, among other efforts.

Only 31 percent of U.S. primary care physicians said they are notified when a patient is discharged from the hospital or seen in an emergency department. The Netherlands scored the highest on this measure with 69 percent of doctors reported they were always notified at discharge.

U.S. primary care doctors led the survey for arranging after-hours care for patients without going to the emergency department at just under 40 percent. Countries ranking the worst on this measure were The Netherlands at 94 percent, New Zealand at 92 percent and the U.K. at 89 percent. Only 6 percent of physicians surveyed in the U.S. were able to make home visits, compared with more than 80 percent in the Netherlands and the U.K.

The U.S. also led the survey in the use of health IT. EHR adoption has tripled since 2006, 57 percent of U.S. primary care practices reported communicating with patients via email and 60 percent allow patients to access their medical record electronically. Only 52 percent of doctors reported being satisfied with their EHRs, however.

To ensure affordable, high-quality healthcare for sick and complex patients, the U.S. needs to improve its primary care infrastructure to make it easier for patients to get care outside regular business hours, facilitate provider communication and enable access to social services, the author concluded.