BMJ  2003;327 (29 November), doi:10.1136/bmj.327.7426.0-g

Editor's choice

The NHS experiment

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

Ownership and integration—two attributes that typify Kaiser Permanente, a healthcare organisation that provides managed care to 8.2 million Americans. Last year's BMJ paper by Richard Feachem and colleagues compared the NHS unfavourably with Kaiser and produced a strong reaction. Many of you argued this was a comparison of apples and oranges, fatally flawed; others believed that Kaiser could be a model for the NHS. A major difference between the two systems was bed usage—the NHS used three times the number of acute bed days. One GP reader wrote: "Senior NHS representatives should visit the US system described, try to work out why patients spend far less time in hospital, and then start applying the lessons learned."

Chris Ham and colleagues followed most of that advice. They examined routine data for the 11 leading causes of acute hospital admission (p 1257). Ham interviewed Kaiser's senior clinical and managerial staff, . . . [Full text of this article]

(kabbasi@bmj.com)

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Articles

What do we gain from the sixth coronary heart disease drug?

Rebecca N Warburton
BMJ 2003 327: 1237-1238. [Extract] [Full Text] [PDF]

Is the NHS getting better or worse?

Richard Smith
BMJ 2003 327: 1239-1241. [Extract] [Full Text] [PDF]

Lessons for the NHS from Kaiser Permanente

Jonathan Shapiro and Sarah Smith
BMJ 2003 327: 1241-1242. [Extract] [Full Text] [PDF]

Should we be screening for and treating amblyopia?

Gordon N Dutton and Marie Cleary
BMJ 2003 327: 1242-1243. [Extract] [Full Text] [PDF]

Nuffield Trust praises ambitious NHS plans but calls for better monitoring

Annabel Ferriman
BMJ 2003 327: 1250. [Extract] [Full Text] [PDF]

Randomised controlled trial of treatment of unilateral visual impairment detected at preschool vision screening

M P Clarke, C M Wright, S Hrisos, J D Anderson, J Henderson, and S R Richardson
BMJ 2003 327: 1251. [Abstract] [Full Text] [PDF]

Randomised controlled trial of smoking cessation intervention after admission for coronary heart disease

Petter Quist-Paulsen and Frode Gallefoss
BMJ 2003 327: 1254. [Abstract] [Full Text] [PDF]

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]

Coronary heart disease prevention: insights from modelling incremental cost effectiveness

Tom Marshall
BMJ 2003 327: 1264. [Abstract] [Full Text] [PDF]

Predictive accuracy of the Framingham coronary risk score in British men: prospective cohort study

Peter Brindle, Jonathan Emberson, Fiona Lampe, Mary Walker, Peter Whincup, Tom Fahey, and Shah Ebrahim
BMJ 2003 327: 1267. [Abstract] [Full Text] [PDF]

Online poll

Find out more >>