Skip to main content

All Access Subscription

Get unlimited access to our full publication and article library.

Get Access Now

Interested in Group Sales? Learn more

Hospital Report logo small


The premier resource for hospital professionals from Relias Media, the trusted source for healthcare information and continuing education.

Report: United States Still Lags in Women's Healthcare Outcomes

By Jill Drachenberg, Editor, Relias Media

Maternal mortality rates and high out-of-pocket medical costs continue to climb compared to 10 other high-income countries, according to a new report from the Commonwealth Fund.

The study compared access to healthcare and health outcomes for women in the United States to women in Australia, Canada, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. Maternal mortality rates in the U.S. are 14 per 100,000 live births. Sweden has the lowest rate, at 4 deaths for every 100,000 births.

While passage of the Affordable Care Act in the U.S. brought greater access to coverage and needed preventive screenings, care dissatisfaction and care costs continue to rise, according to the report. Other findings include:

  • High rates of chronic diseases such as diabetes, heart disease, and obesity, less access to prenatal care, and high rates of cesarean sections are factors that contribute to higher maternal mortality.
  • Switzerland and Australia report the highest cesarean section rates at 327 and 332, respectively, per 1,000 live births. The U.S. is the third-highest at 320 per 1,000 live births. Reasons for this may include “a combination of a country’s specific health system, physician and patient preferences, cultural factors, population characteristics, and payment incentives,” according to the report.
  • Sweden and the U.S. lead the 11 countries in breast cancer screenings, while Switzerland has the lowest rates.
  • Women in Switzerland and the U.S. pay the highest out-of-pocket medical costs, at $2,000 or more per year. “No more than one of 20 women reported such high costs in most other countries included in the study,” the authors reported.
  • Thirty-eight percent of U.S. women forgo needed care due to high costs and lack of insurance coverage. Only 5% of women in the U.K. reported this problem.
  • When it comes to wait times for specialist visits, only 26% of U.S. women had to wait four weeks or more for an appointment — the lowest rate out of the 11 countries studied. Canada, Norway, and New Zealand report the longest wait times.

The U.S. spends more per year on healthcare than any other country, yet continues to lag behind other countries when it comes to low access to primary care, poorer outcomes, and high rates of chronic diseases.

“Since research suggests that the differences in health spending between the U.S. and the rest of the world stem largely from higher prices, payment and delivery system reform must be at the top of the nation’s policy agenda,” the study authors concluded. “Bringing health costs under control will help improve access to health insurance and health care.”

For more information on managing chronic conditions and care coordination, see Hospital Case Management and Case Management Advisor.