Healthcare up close: Local perceptions about healthcare around the world

Healthcare up close: Local perceptions about healthcare around the world

28 December 2022 | 15min

There are various viewpoints surrounding the different healthcare systems around the world. Each country has a unique approach when it comes to delivering and organizing their healthcare. Analyzing medical care can be complex – from healthcare costs to service delivery systems, there are several different factors that determine the effectiveness of a healthcare provider. At Healthcare Transformers, we wanted to gain an understanding of both men’s and women’s individual experiences with their countries’ healthcare management, directly from the people using these services. 

We commissioned a survey sent to 11,000 men and women in 11 countries worldwide to learn more about their local personal healthcare experiences and perceptions. We surveyed 1,000 adults in each country (UK, US, Brazil, China, France, Germany, India, Italy, Japan, South Africa, and Spain) from a random sample of the general population. The age demographics of respondents varied from 18 years and older.  

Throughout our research, we asked each participant in the survey to share their perspectives on a range of data points. 

These included:

  • Healthcare costs
  • Healthcare quality and access
  • Confidence in the medical system in their country
  • Whether they feel their health needs are met 

Read on to learn more about the differing perceptions surrounding healthcare held by men and women around the world. 

*The full methodology can be found in the reference section below. 

Healthcare across the globe 

Throughout this study, we have analyzed a range of market demographics including adults in the UK, US, Brazil, China, France, Germany, India, Italy, Japan, South Africa, and Spain. 

Our pulled data suggests, almost half of all surveyed respondents (45%) feel their healthcare payments are too high. 

31% of South African respondents believe that their healthcare costs are too high, which was the highest percentage amongst all 11 countries analyzed. Research has shown this could be because of South Africa’s two-tier healthcare system. With a large subsidized public sector and a small and superior, very high-quality private sector – there is a large proportion of funding and specialists going into the private sector. This means in South Africa, it is advised residents take out the private plan, which in turn, could account for why respondents felt their healthcare costs were too high.

61% of residents in China rated their healthcare as an appropriate cost, with only a small 4% of all respondents rating their healthcare costs as too high – this was the lowest percentage amongst all countries. Research has shown, over the past decade, China has built a new comprehensive health system improvement, concentrating on strengthening the capacity of primary care, extending and improving social health insurance coverage, providing basic public health services to all residents, as well as reforming public hospitals, and improving medicine policies. This recent implementation could suggest why Chinese residents are for the most part happy with their healthcare costs. What’s more, our data further highlights, 40% of Chinese respondents are “extremely confident” in their healthcare, which was the highest percentage amongst all countries analyzed. 

When we asked all surveyed countries to rate their confidence in healthcare provision on a scale of 0-10, 15% of respondents across all countries rated their country’s services at 4 or less – highlighting a considerable number of people worldwide who have very low confidence in their healthcare system. 

According to our polling, the UK, South Africa, the US, and Brazil have the least confidence in their healthcare system – with Italy following closely behind. Brazil’s confidence in its healthcare system is so low that nearly 42% of respondents claim they have “very often” been outright dismissed by a doctor when seeking treatment. Similarly, 24% of South Africans claim medical diagnoses have frequently been delayed unnecessarily due to healthcare professionals not taking a patient’s symptoms seriously the first time around. 

When comparing worldwide averages, UK residents rated confidence in their healthcare system the lowest out of all countries polled. With an average rating of 5.9/10, the UK’s results pale in comparison to the positive 8.7/10 rating from China’s residents. The US didn’t fare much better, scoring confidence at 6.2/10. 

Research shows; trust and confidence are key components of the clinician-patient relationship in healthcare. There are many benefits that can arise from a trusting relationship, including open communication of information, improved adherence to medical advice, improvement of health outcomes, and better patient experience. 

What’s more, the World Health Organization states, informed patients are more likely to feel confident to report both positive and negative experiences and have increased concordance with mutually agreed care management plans. This not only improves health outcomes but also advances learning and improvement while reducing adverse events. 

CountryConfidence in the healthcare system
0 – Not confident at all
10 – Extremely confident
UK5.9
South Africa6.0
Brazil6.2
US6.2
Italy6.7
Japan 7.0
France7.1
Germany 7.2
Spain 7.3
India 7.6
China8.7

Healthcare in the UK

In the UK, the National Health Service (NHS) is a publicly funded healthcare system paid by all citizens through taxes. The NHS acts as a universal safety net, providing healthcare services at no cost at the point of use for the vast majority of its activities. This stands in contrast to countries where healthcare and health providers are privately funded. 

Our study shows that over a quarter (27%) of UK respondents rated their confidence in the healthcare service as 4 out of 10 or lower due to a variety of different factors. In particular, 61% of UK respondents claim to have been dismissed by a healthcare professional, and 1 in 10 “never” or “rarely” feel supported by the healthcare system.  

However, we also identified a notable disparity in confidence between men and women, as well as non-binary respondents. We found that men are much more likely to express confidence in the UK healthcare system versus women and non-binary individuals. Our survey showed that 13% of women and non-binary respondents rated their confidence in the UK healthcare a 3/10 or less, whereas only 5% of men said the same. Conversely, 14% of men scored confidence at a 9/10 or higher, compared to just 7% of women. 

A similar lack of confidence also appears when female-identifying respondents were asked about women’s health services in the UK, with only half (53%) believing their concerns are “always” or “mostly” addressed. 

Region appears to play a limited role in confidence, as much of the UK is relatively aligned in how they feel about their healthcare system. While individuals might perceive certain regions (North vs. South or rural vs. urban) to have significantly better healthcare options, our poll data suggests only minor fluctuations in confidence. For example, London is more confident in its systems (9% responded they’re “extremely confident”) when compared to Northern Ireland (0% “extremely confident”) but neither area varies drastically from UK averages when looking at all data points. 

Region% of people who are “extremely confident”
in the healthcare system
West Midlands14%
Wales14%
South West9%
London9%
North East 8%
North West7%
Yorkshire and The Humber6%
East Midlands4%
South East 4%
Scotland2%
Northern Ireland0%
East Anglia0%

When we asked those surveyed how long on average it takes them to be seen by a doctor or healthcare professional in the UK, 39% answered that it usually takes them around 2-3 weeks to secure an appointment. Only 8% revealed they would typically be seen on the same day. 

This stands in sharp contrast with South Africa, which has the shortest wait time for healthcare appointments, with 40% of candidates being seen by a medical professional on the same day, and 41% being seen within a week according to the survey responses. 

Country% of people who have to wait over
2 weeks for an appointment 
South Africa15.42%
Japan21.51%
China31.85%
US33.30%
India35.07%
France36.15%
Brazil36.93%
UK39.13%
Italy39.45%
Spain40.47%
Germany48.08%

From a more global perspective, the UK ranks average among the 11 countries polled regarding the wait time for securing an appointment with a healthcare professional around 2-3 weeks. 

Healthcare in the US

According to the Organization for Economic Cooperation and Development (OECD), the United States spends significantly more per capita on healthcare than any other nation worldwide. Our research suggests that this is felt by citizens as well, with 51% of US participants in our survey indicating that the cost of healthcare in the US is overpriced. 

Despite the high healthcare spending, 80% of US residents still feel they have experienced a delay in a medical diagnosis due to their symptoms not being taken seriously by a doctor or healthcare professional. This is by far the highest percentage out of all of the 11 countries we surveyed. To put this number in perspective, the second-highest was a full 11% less – Spain at 69%. 

Country% of people who have experienced a delay
US80%
Spain69%
India68%
Germany66%
Brazil65%
Italy62%
France57%
UK57%
South Africa51%
China37%
Japan30%

Of the 80% in the US, 51% believed they’d been unnecessarily delayed “many times”, whereas only 34% of respondents in Spain reported feeling the same. 

Additionally, 38% of US residents feel that a doctor or healthcare provider has outright dismissed their symptoms or not taken their symptoms seriously – Brazil ranked the highest in this aspect with 42%. 

US responses suggest that region plays a large role in America when it comes to healthcare confidence. In particular, respondents in the Midwest had a much more favorable view of healthcare providers when compared to those living in the Northeast and Southeast. 70% of Midwesterners reported satisfaction of 6/10 or higher – compared to 56% of Northeastern and 47% of Southeastern respondents. 

That said, it’s not as simple as East vs. West. The data suggests Midwestern states have the most confidence in their healthcare systems than any other region in the US, reporting 56% – closely followed by 47% of Southwesterners. 

To further back up the claim that Midwesterners are disproportionately happy with their healthcare, this group also had the highest number of respondents (at 40%) claiming premiums were appropriate – as well as the lowest number of people who believe their insurance cost is too high (39%). In comparison, nearly every other region saw over 50% of respondents claim costs were too high – with 59% of Northeastern residents claiming that their healthcare bills were too high, closely followed by the Southwest (54%) and Southeast (52%).  

Female-identifying survey participants indicated lower confidence in the US healthcare system than men. 23% of women and non-binary reporters gave their confidence in US healthcare a 3/10 or less – whereas only 11% of men said the same. Dissatisfaction is still highly divergent but, on the other end of the spectrum, men and women are more aligned: 28% of men and 24% of women reported a 9/10 or higher confidence.

In terms of specific data of note: out of the 11 countries polled, 59% of all respondents (63% of females and 54% of males) that were US residents have discussed fertility with their healthcare provider, putting the US in the third position behind China and India. 

When it comes to pregnancy, the US has the 3rd highest percentage of surveyed residents stating that they believe their health and wellbeing were taken care of by a doctor/healthcare professional, as well as that of their baby, at 31%. Brazil tops the rankings, closely followed by India. Japan has the lowest number of respondents voting that they “always” felt the health and well-being of themselves and their baby was taken care of at 9% and 17% of respondents voting that they “sometimes” felt this was the case.  

Among US respondents, a high percentage of women had a cervical smear screening within the past year (36%). Both Brazil and Germany top the rankings with 48% and 51% of women having a smear test in the past year.  

Dr. Google

Interestingly, 97% of all respondents worldwide stated that they have used the internet to search for their symptoms and/or health issues at least once before they saw a doctor or healthcare professional. 

When it comes to making a habit of searching the internet for symptoms, the US scored the highest out of all of the countries surveyed as most likely to regularly go online to search for their symptoms, with 93% of respondents using the internet “always”, “most of the time” or “sometimes” before seeking help from a healthcare professional. 

Thanks to Google and an ever-increasing number of technological advances at hand, individuals all around the world are able to seek quick answers to their health issues through a simple internet search. What’s more, since the pandemic, people have become increasingly more engaged with their health and well-being, taking more ownership in self-care and lifestyle improvements, such as exercise and diet. 

Country% that regularly Google symptoms
before seeing a professional 
US93%
India91%
China 89%
South Africa89%
Italy 88%
Brazil86%
UK 85%
Spain84%
France84%
Germany 80%
Japan 73%

Women and healthcare

From cervical cancer screening to support in fertility, prenatal testing, and pregnancy care, to breast and ovarian cancer diagnosis to managing bone health, women’s health is supported by a wide range of healthcare consultations and services specific to their needs. 

Interestingly from our data, only 21% of female-identifying respondents feel as though all of their health concerns have been addressed or followed up with concrete actions when visiting a doctor for women’s health issues. 

The US ranks the highest out of all respondents for believing all of their health concerns are always addressed – 33% of female-identifying respondents in total. Throughout all 11 countries, Japan ranked the lowest with only a small 7% of female-identifying respondents feeling as though all of their women’s health issues were followed up with concrete actions. In fact, 17% of female-identifying respondents in Japan confessed they had never been to a health professional about their women’s health issues – the highest rate amongst the surveyed countries. 

US men and women are also the most likely to discuss fertility with their healthcare provider (59%). Japan, again, ranked the lowest with 76% of participants stating that they have never spoken about fertility with their doctor. 

According to the WHO, cervical cancer is the fourth most common cancer among women globally, with an estimated 604,000 new cases and 342,000 deaths in 2020. About 90% of the new cases and deaths worldwide in 2020 occurred in low- and middle-income countries.

A cervical screening, also known as a smear test, is one of the best ways women can prevent cervical cancer. This screening procedure for cervical cancer is offered to women between the ages of 25 and 64 – during the test a sample of cells is removed from the cervix and checked for the presence of precancerous or cancerous cells that may be present on your cervix. The Pap test may be combined with a test for the human papillomavirus (HPV), a common sexually transmitted infection that can cause cervical cancer. The Centre for Disease Control and Prevention states ‘the Pap test (or Pap smear) looks for precancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately. Whereas the HPV test looks for the virus (human papillomavirus) that can cause these cell changes.

The American Cancer Society recommends that all women between the ages of 25 and 65 do an HPV test every five years, and in the UK every 3 or 5 years, depending on age. That said, only 37% of females have been for an HPV test in the last 3-5 years (or less), a whopping 30% answered that they don’t undergo regular screening for HPV at all, and 12% stated that they did not know what HPV is or were unsure if they had been screened for it. 

Shockingly, almost one in five (19%) of all women and female-identifying women surveyed, aged between 25 and 64, have not been for a smear test in the last 5 years or never at all.

In the UK, only 23% of respondents stated that they had a smear test in the last year, the lowest percentage among all countries surveyed. The US landed in the middle with 36% of respondents, with Brazil coming out on top with 48% of all respondents stating they had undergone a cervical smear in the past year. 

Country% of women who have never been for a
smear test
US5%
UK9%
China11%
Germany 12%
France 15%
Brazil17%
Italy 22%
India 27%
Japan 31%
Spain33%
South Africa34%

While the US and UK might not be as vigilant about annual smear tests, they did rank the lowest for the number of respondents who have never been tested – at 5% and 9%, respectively. 

Unfortunately, many of the other countries we surveyed had much higher rates for this figure – with 1 in 3 (34%) South African respondents reporting they’d never had a smear test (Spain and Japan were close behind with 33% and 31%).  

Shockingly, our data highlights almost one in five (19%) of all women and female-identifying women surveyed, aged between 25 and 64, have not been for a smear test in the last 5 years or never at all. 

What’s more, our research has additionally shown that 14% of all respondents – more than one in 10 people responded “I do not know what HPV is/not sure” to the question “How often, if at all, do you undergo screening for human papillomavirus (HPV)?” 33% stated, “I don’t undergo regular screenings for HPV.” With this in mind, it is immensely important that healthcare systems all around the world invest in educating women about HPV and its implication in cervical cancer and encourage access to regular HPV and cervical screenings. 

WHO now encourages countries to use HPV tests for cervical screening, including HPV DNA and HPV mRNA tests. 

Research has shown that the pandemic severely affected healthcare for both girls and women. Because of this, it is imperative that global and local communities take the necessary steps to improve their social security and bridge the gaps in the provision of essential health services. Failure to do so may, in turn, lead to serious health issues and misdiagnoses. 

Women’s and men’s healthcare

When we compared both women’s and men’s data results, we found generally that both men and women around the world feel that a doctor or healthcare professional has dismissed them or not taken their worries seriously. Similarly, 29% of both men and women, and 28% of those who identify as non-binary, declared only “sometimes” having confidence in their healthcare system. 

Our data highlights that women marginally have less faith in the healthcare system than men, with 66% of women feeling that they have to frequently research their symptoms before seeing a healthcare professional, in comparison to 55% of men. 

When it comes to fertility, women are typically more likely to chat about their concerns regarding fertility, 43% of women vs 33% of men. 

Interestingly, despite the increase in digital and virtual health in recent years, we found that typically men and women prefer to receive their healthcare in person. Men, women, and those who identify as non-binary traditionally prefer to get in touch with their healthcare provider in similar ways – 65% of females, 62% of males, and 58% of non-binary candidates prefer physical and in-person appointments.

Healthcare Transformers Insights are expert insights, opinions and strategies aimed at helping healthcare executives deliver improved patient care and financial value across the continuum of care.

References

Methodology

This survey was conducted by Healthcare Transformers and One Poll in 2022. The demographics include an analysis of adults in Brazil, China, France, Germany, India, Italy, Japan, South Africa, Spain, UK and US. The candidates were contacted through the One Poll database.

The sample focuses on 1000 people from each country, randomly selected from the general population and consisting of 5,935 women, 4,989 men, 45 non-binary and 31 who prefer not to say. The survey also consists of 2,005 18-24 year-olds, 3,307 25-35 year-olds, 3,038 36-44 year-olds, 1,476 45-54 year-olds, 749 55-64 year-olds and 425 65+. 

 

Survey respondent demographics

Country  Age group  No. of respondents Men  (% of total) Women (% of total) Non Binary (% of total) Prefer not to say (% of total)
Brazil 18-24 203 484 (49%) 512 (51%) 4 (0%) 1 (0%)
25-35 347
36-44 287
45-54 120
55-64 35
65+ 8
China 18-24 104 393 (39%) 588 (59%) 8 (1%) 11 (1%)
25-35 363
36-44 366
45-54 147
55-64 12
65+ 8
France 18-24 215 333 (33%) 663 (66%) 2 (0%) 2 (0%)
25-35 315
36-44 254
45-54 127
55-64 69
65+ 20
Germany 18-24 228 (458 (46%) 542 (54%) 0 (0%) 0 (0%)
25-35 309
36-44 215
45-54 131
55-64 81
65+ 36
India 18-24 250 602 (60%) 398 (40%) 0 (0%) 0 (0%)
25-35 332
36-44 311
45-54 78
55-64 26
65+ 3
Italy 18-24 235 471 (47%) 525 (53%) 4 (0%) 0 (0%)
25-35 282
36-44 249
45-54 156
55-64 60
65+ 18
Japan 18-24 207 468 (49%) 512 (51%) 8 (1%) 12 (1%)
25-35 235
36-44 209
45-54 159
55-64 109
65+ 81
South Africa 18-24 267 384 (38%) 602 (60%) 10 (1%) 4 (0%)
25-35 340
36-44 253
45-54 93
55-64 35
65+ 12
Spain 18-24 207 478 (48%) 517 (52%) 4 (0%) 1 (0%)
25-35 293
36-44 236
45-54 143
55-64 93
65+ 28
UK 18-24 74 457 (46%) 540 (54%) 3 (0%) 0 (0%)
25-35 205
36-44 192
45-54 185
55-64 168
65+ 176
US 18-24 15 461 (46%) 537 (54%) 2 (0%) 0 (0%)
25-35 286
36-44 466
45-54 137
55-64 61
65+ 35

 

Survey questions 

  1. Generally, how confident are you in the healthcare provision in your country?
  2. Generally, how often do you feel supported by your healthcare?
  3. How would you say the cost of your overall healthcare is?
  4. Have you ever felt a doctor or healthcare professional has dismissed you or not taken symptoms or worries seriously?
  5. Have you ever experienced a delay in a medical diagnosis due your symptoms not being taken seriously by a doctor or healthcare professional?
  6. How often do you research your symptoms/health issues before you see a doctor/healthcare professional?
  7. How long does it usually take for you to be seen once you contact your healthcare provider for a general appointment?
  8. Are your general doctor’s/healthcare appointments more often in-person or virtual e.g. telephone or video call?
  9. What would be the preferred format of your general appointments/consultations with your doctor/healthcare professional?
  10. Have you ever discussed fertility with your doctor/healthcare professional?
  11. How often, if at all, do you undergo screening for human papilloma virus (HPV)?

 

Female-specific questions: 

  1. When you visit a doctor for women’s health issues, how often do you feel like all of your health concerns have been addressed and/or followed up with concrete actions? Some examples of women’s health issues are: fertility, smear test, vaginal tests, contraceptives appointments, menopause treatment, urinary tract infections etc. 
  2. How often during your pregnancy did (or do) you feel that your health and wellbeing was taken care of by a doctor/healthcare professional, as well as that of your baby?
  3. When did you last go for a smear test/pap smear test?

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