The United States has the most costly health system in the world. But the country consistently does a worse job of taking care of its sick than selected health systems in other industrialized countries on most measures, a new study finds. The May report from the New York-based Commonwealth Fund examined health systems in the U.S. and five other industrialized nations. It found the U.S. ranked last or next-to-last on quality, access, efficiency, equity and healthy lives. One reason for the poor performance is that the U.S. was the only country in the study without universal health insurance coverage. That hurt its scores on access, equity and health outcomes, the authors said. The inclusion of physician survey data also showed the country lagging in adoption of information technology and the use of nurses to improve care coordination for the chronically ill. The full report can be found online on the website for the Commonwealth Fund, a foundation that promotes access, quality and efficiency in healthcare systems.