Despite spending more per capita on care, the United States ranks last on several key healthcare measures, two surveys of patients in six nations released Tuesday found.

The U.S. healthcare system ranked last on patient safety, efficiency, equality and its ability to focus on a patient’s needs, according to two new surveys from the Commonwealth Fund. The report measured patients’ healthcare experiences in Australia, Germany, Canada, New Zealand and the United Kingdom. One report looked at overall performance based on patient experiences in two surveys. The other examined patients’ experiences with primary care by income.

Among the findings, the U.S. performed the worst when it came to receiving a laboratory test error, getting the wrong test or waiting a long time to receive abnormal test results. The United States also ranked last on patients who reported that they left a doctor’s appointment without having their questions answered.

In addition, patients reported that they were more likely to seek treatment in an emergency room for a condition that could have been treated by a regular doctor. A Commonwealth Fund survey released late last year fount that the United States led the same six countries in its rate of medical mistakes.

U.S. patients with lower incomes were more likely to experience poor primary care access, coordination and relationships with their physicians than their counterparts in other countries. Economic differences in healthcare based on income were rare in all other countries surveyed. Patients in the United Kingdom reported the most equitable care experiences by income.

There were a few bright spots for the U.S. healthcare system in the survey. The United States ranked first on providing preventive care, such as pap tests, mammograms and diet and exercise counseling, to patients. However, U.S patients were less likely than their counterparts in other nations to fill a prescription and were more likely to forgo recommended tests, treatments and follow-ups due to cost concerns.

“We have serious issues in quality of care in all of the countries surveyed,” said Don Berwick, MD, president and CEO of the Institute for Healthcare Improvement.

Contrary to the widely held belief that the United States has the best healthcare system in the world, it actually spends more and provides worse care to patients than those in other countries, Berwick said, noting that advances in the use of medical technology do not translate into better coordination of care.

IT one of several building blocks for improvement

The use of information technology is a “constructive building block” to improving the U.S. healthcare system, said Karen Davis, president of the Commonwealth Fund. However, with only 25 percent of physicians using an electronic medical record, more needs to be done, she said. Emphasis should also be placed on coordinating care, improving primary care and redesigning the healthcare system to improve patient safety, she said.