BMJ  2004;328:583-584 (6 March), doi:10.1136/bmj.328.7439.583-b

Letter

Hospital bed utilisation in the NHS and Kaiser Permanente

Quality of care, length of stay, and readmissions need to be considered

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

EDITOR—Ham et al report that bed days used for a range of common diagnoses among people aged 65 and over are substantially higher in the NHS than in US managed care programmes.1

Stroke admissions contribute most to the extra bed days in the NHS and also show the largest relative differences from the US comparators. Comparable incidences are not available, but mortality, a reasonable proxy, shows that the United States has much lower rates of stroke than the United Kingdom: age adjusted stroke mortality in the United States is about 35% lower at age 35-74 and 49% at age 75-84.2

However, admission rates for Medicare in California and the United States are about 45% higher than in the NHS, Kaiser's rates being broadly similar. The higher Medicare stroke admission rates in the face of lower incidence seem likely to be due to a higher proportion of readmissions among . . . [Full text of this article]

Shah Ebrahim, professor of epidemiology of ageing

Shah.Ebrahim@bristol.ac.uk

Stephen Frankel, professor of epidemiology and public health

George Davey Smith, professor of clinical epidemiology

Department of Social Medicine, University of Bristol, Bristol BS8 2PR


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

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]

This article has been cited by other articles:

  • Profit, J, Zupancic, J A F, McCormick, M C, Richardson, D K, Escobar, G J, Tucker, J, Tarnow-Mordi, W, Parry, G (2006). Moderately premature infants at Kaiser Permanente Medical Care Program in California are discharged home earlier than their peers in Massachusetts and the United Kingdom. Arch. Dis. Child. Fetal Neonatal Ed. 91: F245-F250 [Abstract] [Full text]  
Access jobs at BMJ Careers
Whats new online at Student BMJ