BMJ  2004;328:583 (6 March), doi:10.1136/bmj.328.7439.583

Letter

Hospital bed utilisation in the NHS and Kaiser Permanente

Do not throw the baby out with the bath water

The first 150 words of the full text of this article appear below.

EDITOR—The NHS is a learning organisation, and the secretary of state for health recently warned the critics opposed to learning from other healthcare systems.1 Ham et al have been criticised for not presenting evidence for the conclusion that Kaiser's better bed utilisation is due to integration of care, active management, use of intermediate and self care, and leadership.2

According to the authors, one of them interviewed senior clinical and managerial staff and visited Kaiser facilities to gather data. It is hard to quantify this type of qualitative data. However, evidence shows that Kaiser's chronic care programme management has reduced emergency department visits.3 A randomised controlled trial in a Kaiser facility found that a multidisciplinary outpatient diabetes care management programme reduced both inpatient and outpatient utilisation.4 Kaiser is the market leader in providing and implementing self-management support for patients.5

In the 21st century the NHS should be open to . . . [Full text of this article]

P Badrinath, specialist registrar in public health

Southend Primary Care Trust, Southend on Sea, Essex SS2 6HE p.badrinath@southend-pct.nhs.uk


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Relevant Article

Hospital bed utilisation in the NHS, Kaiser Permanente, and the US Medicare programme: analysis of routine data
Chris Ham, Nick York, Steve Sutch, and Rob Shaw
BMJ 2003 327: 1257. [Abstract] [Full Text] [PDF]

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