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This fascinating editorial raises further questions regarding the impact of total deaths, as opposed to age-standardized mortality, upon the pressures currently being experienced in the NHS. All will be aware that the NHS appears to be experiencing an endless 'winter' regarding the volume of medical admissions and associated A&E attendances.
Indeed, contrary to forecasts made by the Office for National Statistics (ONS), the absolute number of deaths are currently at levels anticipated to occur some 15 to 20 years into the future [1].
The last year of life marks a period of intense usage of acute care when over 55% of a person's lifetime acute bed consumption will occur [2]. Hence changes in medical admissions and bed occupancy, hospital standardized mortality (HSMR), hospital costs, NHS staff sickness absence and the human gender ratio at birth all seem to track the absolute number of deaths occurring in a location [3-6].
This unanticipated increase in total deaths and medical admissions appears to behave in a manner reminiscent of an infectious outbreak, i.e. occurs at very small area level, which precedes the imposition of austerity [7-10].
Hence, whatever the cause, all concerned do need some answers on this vitally important topic - other than the totally unsatisfactory answers presented by government agencies seeking to assure us that all is well [9-10].
References
1. Jones R. What the ONS ‘forgot’ to mention about deaths. Brit J Healthc Manage 2017; 23: in press
2. Beeknoo N, Jones R. The demography myth - how demographic forecasting underestimates hospital admissions, and creates the illusion that fewer hospital beds or community-based bed equivalents will be required in the future. Brit J Med Medical Res 2016; 19(2): 1-27. doi: 10.9734/BJMMR/2017/29984
3. Jones R. Unusual trends in NHS staff sickness absence. Brit J Healthc Manage 2016; 22(4): 239-240.
4. Jones R. Outbreaks of a Presumed Infectious Agent Associated with Changes in Fertility, Stillbirth, Congenital Abnormalities and the Gender Ratio at Birth. Brit J Med Medical Res 2017; 20(8): 1-36. doi: 10.9734/BJMMR/2017/32372
5. Jones R. Recurring Outbreaks of an Infection Apparently Targeting Immune Function, and Consequent Unprecedented Growth in Medical Admission and Costs in the United Kingdom: A Review. Brit J Med Medical Res 2015; 6(8): 735-770. doi: 10.9734/BJMMR/2015/14845
6. Jones R. A ‘fatal’ flaw in hospital mortality models: How spatiotemporal variation in all-cause mortality invalidates hidden assumptions in the models. Fractal Geometry and Nonlinear Analysis in Medicine and 2015; 1(3): 82-96. doi: 10.15761/FGNAMB.1000116
7. Jones R. Year-to-year variation in deaths in English Output Areas (OA), and the interaction between a presumed infectious agent and influenza in 2015. SMU Medical Journal 2017; 4(2): in press
8. Jones R. Role of social group and gender in outbreaks of a novel agent leading to increased deaths, with insights into higher international deaths in 2015. Fractal Geometry and Nonlinear Analysis in Medicine and Biology 2017; 3(1): in press.
9. Jones R. The unprecedented growth in medical admissions in the UK: the ageing population or a possible infectious/immune aetiology? Epidemiology (Sunnyvale) 2016; 6(1): 1000219. http://dx.doi.org/10.4172/2161-1165.1000219
10. Jones R. Rising emergency admissions in the UK and the elephant in the room. Epidemiology (Sunnyvale): Open Access 2016; 6(4): 1000261. doi: 10.4172/2161-1165.1000261
Re: Have mortality improvements stalled in England?
This fascinating editorial raises further questions regarding the impact of total deaths, as opposed to age-standardized mortality, upon the pressures currently being experienced in the NHS. All will be aware that the NHS appears to be experiencing an endless 'winter' regarding the volume of medical admissions and associated A&E attendances.
Indeed, contrary to forecasts made by the Office for National Statistics (ONS), the absolute number of deaths are currently at levels anticipated to occur some 15 to 20 years into the future [1].
The last year of life marks a period of intense usage of acute care when over 55% of a person's lifetime acute bed consumption will occur [2]. Hence changes in medical admissions and bed occupancy, hospital standardized mortality (HSMR), hospital costs, NHS staff sickness absence and the human gender ratio at birth all seem to track the absolute number of deaths occurring in a location [3-6].
This unanticipated increase in total deaths and medical admissions appears to behave in a manner reminiscent of an infectious outbreak, i.e. occurs at very small area level, which precedes the imposition of austerity [7-10].
Hence, whatever the cause, all concerned do need some answers on this vitally important topic - other than the totally unsatisfactory answers presented by government agencies seeking to assure us that all is well [9-10].
References
1. Jones R. What the ONS ‘forgot’ to mention about deaths. Brit J Healthc Manage 2017; 23: in press
2. Beeknoo N, Jones R. The demography myth - how demographic forecasting underestimates hospital admissions, and creates the illusion that fewer hospital beds or community-based bed equivalents will be required in the future. Brit J Med Medical Res 2016; 19(2): 1-27. doi: 10.9734/BJMMR/2017/29984
3. Jones R. Unusual trends in NHS staff sickness absence. Brit J Healthc Manage 2016; 22(4): 239-240.
4. Jones R. Outbreaks of a Presumed Infectious Agent Associated with Changes in Fertility, Stillbirth, Congenital Abnormalities and the Gender Ratio at Birth. Brit J Med Medical Res 2017; 20(8): 1-36. doi: 10.9734/BJMMR/2017/32372
5. Jones R. Recurring Outbreaks of an Infection Apparently Targeting Immune Function, and Consequent Unprecedented Growth in Medical Admission and Costs in the United Kingdom: A Review. Brit J Med Medical Res 2015; 6(8): 735-770. doi: 10.9734/BJMMR/2015/14845
6. Jones R. A ‘fatal’ flaw in hospital mortality models: How spatiotemporal variation in all-cause mortality invalidates hidden assumptions in the models. Fractal Geometry and Nonlinear Analysis in Medicine and 2015; 1(3): 82-96. doi: 10.15761/FGNAMB.1000116
7. Jones R. Year-to-year variation in deaths in English Output Areas (OA), and the interaction between a presumed infectious agent and influenza in 2015. SMU Medical Journal 2017; 4(2): in press
8. Jones R. Role of social group and gender in outbreaks of a novel agent leading to increased deaths, with insights into higher international deaths in 2015. Fractal Geometry and Nonlinear Analysis in Medicine and Biology 2017; 3(1): in press.
9. Jones R. The unprecedented growth in medical admissions in the UK: the ageing population or a possible infectious/immune aetiology? Epidemiology (Sunnyvale) 2016; 6(1): 1000219. http://dx.doi.org/10.4172/2161-1165.1000219
10. Jones R. Rising emergency admissions in the UK and the elephant in the room. Epidemiology (Sunnyvale): Open Access 2016; 6(4): 1000261. doi: 10.4172/2161-1165.1000261
Competing interests: No competing interests