Hospital bed utilisation in the NHS and Kaiser Permanente: Authors' reply

doi:10.1136/bmj.328.7439.584-a

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

Letter

Hospital bed utilisation in the NHS and Kaiser Permanente

Authors' reply

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

EDITOR—We agree with Black that improved bed managementis not expensive and with Badrinath that other evidence supportsour argument that the NHS can learn from Kaiser. Like Evans,we were sceptical of the claims made by Feachem et al in theiroriginal paper,¹ but as the evidence has changed we have beenwilling to change our minds.

Ebrahim et al claim that incidence figures for stroke are notavailable. They seem to have overlooked evidence that showsthat the incidence is only marginally lower in the United Statesthan in England (362 per 100 000 compared with 379 per 100 000).²As admission rates for stroke are also marginally lower in Kaiserthan in the NHS, it is difficult to sustain their argument thatKaiser has much higher rates of readmission. In view of thelower mortality in the United States cited by Ebrahim et alit . . . [Full text of this article]

Chris Ham, director

Strategy Unit, Department of Health, London SW1A 2NS chris.ham@doh.gsi.gov.uk

Nick York, senior economic adviser, Rob Shaw, economic adviser

Economics and Operational Research Division, Department of Health, Leeds LS2 7UE

Steve Sutch, senior consultant

NHS Information Authority, Winchester SO22 5DH

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