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

Letter

Hospital bed utilisation in the NHS and Kaiser Permanente

Debate about Kaiser needs transparency and hard evidence

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

EDITOR—The article by Feachem et al comparing Kaiser with the NHS attracted much attention, not least from the Department of Health.¹ However, the authority of the debate is diluted by the way in which the article by Ham et al was published.²

Firstly, Ham did not declare any competing interests. The Department of Health, for which he is strategy director, is currently running pilot studies in seven primary care trusts, adapting elements of the Kaiser model. He therefore has a vested interest in showing that the model his team has advocated performs better than the NHS.

Secondly, the conclusions of the paper were presented as fact in the summary box "What this study adds." The paper implies that Kaiser has accomplished its better acute bed utilisation through integration of care, active management of patients, and the use of intermediate care, self care, and medical leadership. Neither it nor . . . [Full text of this article]

Chesterfield and North Derbyshire Royal Hospital NHS Trust, Chesterfield S44 5BL dae28@hotmail.com

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

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]

Getting more for their dollar: a comparison of the NHS with California's Kaiser Permanente • Commentary: Funding is not the only factor • Commentary: Same price, better care • Commentary: Competition made them do it

Richard G A Feachem, Neelam K Sekhri, Karen L White, Jennifer Dixon, Donald M Berwick, and Alain C Enthoven
BMJ 2002 324: 135-143. [Abstract] [Full Text] [PDF]

Online poll

Find out more here>> and here>>