Hospital bed utilisation in the NHS and Kaiser Permanente: Authors did not compare like with like

doi:10.1136/bmj.328.7439.584

BMJ 2004;328:584 (6 March), doi:10.1136/bmj.328.7439.584

Letter

Hospital bed utilisation in the NHS and Kaiser Permanente

Authors did not compare like with like

The first 100% of the full text of this article appears below.

EDITOR—The analysis by Ham et al seems to be seriouslyflawed by the inability to distinguish NHS acute hospital beddays from stays in community hospitals and similar facilities.¹This is particularly relevant to stroke, which contributes mostto the overall difference, by having long total lengths of stay.

The availability in the Kaiser system of "skilled nursing facilities"with access to therapists would presumably equate to strokerehabilitation facilities in intermediate care in the NHS. Itwould be good to see what effect the inclusion of these beddays makes to the comparison.

Mark L Mallet, consultant physician

Royal United Hospital, Bath BA1 3NG mark.mallet@ruh-bath.swest.nhs.uk

Competing interests: None declared.

Ham C, York N, Sutch S, Shaw R. Hospital bed utilisation in the NHS, Kaiser Permanente, and the US Medicare programme: analysis of routine data. BMJ 2003;327: 1257-60. (29 November.)[Abstract/Free Full Text]

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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]