A survey of 6,000 primary care doctors in seven countries revealed disparities in several areas that affect quality of care.[24] Differences did not follow trends of the cost of care; primary care physicians in the United States lagged behind their counterparts in other countries, despite the fact that the US spends two to three times as much per capita. Arrangements for after-hours care were almost twice as common in the Netherlands, Germany and New Zealand as in Canada and the United States, where patients must rely on emergency facilities. Other major disparities include automated systems to remind patients about follow-up care, give patients test results or warn of harmful drug interactions.