Dr Foster's Case Notes

Discharge destination and length of stay: differences between US and English hospitals for people aged 65 and over

BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7440.605 (Published 11 March 2004) Cite this as: BMJ 2004;328:605

In England, people aged 65 and over comprise 16% of the population but occupy nearly two thirds of general and acute hospital beds. Because of the pressure on capacity and concern about bed blocking, particularly by elderly patients, interest in the use of intermediate care facilities (such as hospices and nursing homes) has grown. The health system in the United States provides an alternative model for the coordinated use of hospital beds and intermediate care facilities.

The bottom line

  • In 2001, average lengths of stay in English NHS hospitals were more than double the average for US Medicare hospitals for all diagnoses for patients aged 65 and over (excluding day cases). For stroke, the figures for the US and England were 6.7 and 26.9 days respectively.

  • 39% …

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