The U.S. spends more than double what other countries spend on medical care, yet U.S. patients are more likely to report medical errors and go without necessary care, according to a new seven-nation survey.

Approximately 12,000 adults in Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States were polled. The U.S. had the highest rates of patients reporting medical test errors, medical mistakes or medication errors. One-third of U.S. patients with chronic conditions reported a medical, medication, or test error in the past two years, according to the Commonwealth Fund. Still, more than $6,600 per capita is spent on healthcare in this country.

The country with the lowest rate of reported errors was Germany with 16% of adults citing an error in their medical care. The study is published online in Health Affairs.