The German health care system in international comparison: a patient perspective.

Background: International health care systems of industrial countries show great differences in organization and financing. During 2008 the Commonwealth Fund interviewed sicker adult patients from eight countries to compare aspects of quality of health care.

Methods: In total, 9633 randomly selected patients from Australia, Canada, France, Germany, The Netherlands, New Zealand, United Kingdom, and the USA were recruited for structured interviews. All participants were adults who reported being in poor health, having a serious illness or disability, having been hospitalized, or having had major surgery in the past two years.

Results: In total, only 34% of participants in Germany rated the quality of their health care as "excellent" or "very good". This fraction was larger in the other countries (up to 66%). Sicker adults in Germany consulted more physicians. Problems with coordination were reported by all countries, in particular concerning the communication between specialist/general practitioner, hospital/general practitioner and the flow of information to the patients.

Conclusions: Although sicker adults report similar experiences and problems with coordination their satisfaction with health care differs internationally. Compared to a similar survey in 2005 the general satisfaction of sicker adults with health care in Germany has improved.