Hospital bed utilisation in the NHS and Kaiser Permanente

doi:10.1136/bmj.328.7439.583-b

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

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

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 …