{"title":"Length of hospital stay for elderly people is substantially higher in the NHS compared with Kaiser Permanente and US Medicare programmes","authors":"David P Sklar MD (Commentary Author)","doi":"10.1016/j.ehbc.2004.03.016","DOIUrl":null,"url":null,"abstract":"<div><h3>Question</h3><p>Does utilization of hospital beds by people aged over 65 years differ in the NHS in England, Kaiser Permanente in California and Medicare in California and the USA?</p></div><div><h3>Study Design</h3><p>Retrospective cohort study.</p></div><div><h3>Main results</h3><p>For all 11 causes of hospital admissions, standardised length of hospital stay for people aged >65 years was highest in the NHS (3.5 times as long as Kaiser, twice as long as Medicare California, and nearly 50% higher than Medicare in the United States). Standardised hospital admission rates for 11 leading causes of hospital admissions in people aged >65 years are generally highest for Medicare recipients in the United States and California, followed by the NHS in England and then Kaiser Permanente in California (see Table 1). However, there are important limitations to the reliability of these findings (see notes).</p></div><div><h3>Authors’ conclusions</h3><p>For 11 leading causes of acute hospital admissions in people aged >65 years, the NHS has generally lower hospital admission rates and longer hospital stays compared with Medicare recipients in the United States and California, and Kaiser Permanente in California.<span><div><div><table><tbody><tr><td><strong>Table 1</strong> Number of hospital admissions (per 100,000 population) and length of stay (days) in people aged >65 years, standardised for English population data.</td></tr><tr><td>Clinical Diagnosis</td><td>NHS</td><td>Kaiser</td><td>Medicare California</td><td>Medicare United States</td></tr><tr><td></td><td>Admissions</td><td>Stay</td><td>Admissions</td><td>Stay</td><td>Admissions</td><td>Stay</td><td>Admissions</td><td>Stay</td></tr><tr><td>Stroke</td><td>823</td><td>27.08</td><td>788</td><td>4.26</td><td>1155</td><td>5.84</td><td>1183</td><td>6.53</td></tr><tr><td>Chronic obstructive pulmonary disease</td><td>699</td><td>9.87</td><td>558</td><td>3.79</td><td>1067</td><td>5.35</td><td>1256</td><td>5.37</td></tr><tr><td>Bronchitis or asthma</td><td>531</td><td>11.73</td><td>141</td><td>3.09</td><td>225</td><td>4.22</td><td>310</td><td>4.41</td></tr><tr><td>Coronary bypass</td><td>144</td><td>13.27</td><td>97</td><td>9.60</td><td>296</td><td>8.63</td><td>321</td><td>9.98</td></tr><tr><td>Acute myocardial infarction</td><td>550</td><td>9.39</td><td>893</td><td>4.35</td><td>675</td><td>5.14</td><td>923</td><td>5.46</td></tr><tr><td>Heart failure/shock</td><td>556</td><td>12.42</td><td>1118</td><td>3.70</td><td>1893</td><td>5.28</td><td>2272</td><td>5.37</td></tr><tr><td>Angina pectoris</td><td>783</td><td>5.88</td><td>152</td><td>2.21</td><td>176</td><td>2.58</td><td>203</td><td>2.56</td></tr><tr><td>Hip replacement</td><td>342</td><td>12.60</td><td>256</td><td>4.54</td><td>602</td><td>5.41</td><td>644</td><td>5.46</td></tr><tr><td>Knee replacement</td><td>344</td><td>11.32</td><td>367</td><td>4.17</td><td>479</td><td>4.54</td><td>557</td><td>4.40</td></tr><tr><td>Hip fracture</td><td>315</td><td>26.88</td><td>388</td><td>4.89</td><td>489</td><td>5.97</td><td>535</td><td>6.47</td></tr><tr><td>Kidney or urinary infection</td><td>396</td><td>15.19</td><td>526</td><td>3.80</td><td>726</td><td>5.11</td><td>708</td><td>5.32</td></tr></tbody></table></div></div></span></p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 3","pages":"Pages 113-115"},"PeriodicalIF":0.0000,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.03.016","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Evidence-based Healthcare","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1462941004000518","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
Abstract
Question
Does utilization of hospital beds by people aged over 65 years differ in the NHS in England, Kaiser Permanente in California and Medicare in California and the USA?
Study Design
Retrospective cohort study.
Main results
For all 11 causes of hospital admissions, standardised length of hospital stay for people aged >65 years was highest in the NHS (3.5 times as long as Kaiser, twice as long as Medicare California, and nearly 50% higher than Medicare in the United States). Standardised hospital admission rates for 11 leading causes of hospital admissions in people aged >65 years are generally highest for Medicare recipients in the United States and California, followed by the NHS in England and then Kaiser Permanente in California (see Table 1). However, there are important limitations to the reliability of these findings (see notes).
Authors’ conclusions
For 11 leading causes of acute hospital admissions in people aged >65 years, the NHS has generally lower hospital admission rates and longer hospital stays compared with Medicare recipients in the United States and California, and Kaiser Permanente in California.
Table 1 Number of hospital admissions (per 100,000 population) and length of stay (days) in people aged >65 years, standardised for English population data.
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