Hospital bed utilisation in the NHS, Kaiser Permanente, and the US Medicare programme: analysis of routine data

Abstract

Objective To compare the utilisation of hospital beds in the NHS in England, Kaiser Permanente in California, and the Medicare programme in the United States and California. Results Bed day use in the NHS for the 11 leading causes is three and a half times that of Kaiser's standardised rate, almost twice that of the Medicare California's standardised rate, and more than 50% higher than the standardised rate in Medicare in the United States. Kaiser achieves these results through a combination of low admission rates and relatively short stays. The lower use of bed days in Medicare in California compared with Medicare in the United States suggests there is a "California effect" as well as a "Kaiser effect" in hospital utilisation. Conclusion The NHS can learn from Kaiser's integrated approach, the focus on chronic diseases and their effective management, the emphasis placed on self care, the role of intermediate care, and the leadership provided by doctors in developing and supporting this model of care.

Thoracic Endometriosis Syndrome: Case Report and Review of the Literature

“…[55][56][57][58][59][60][61][62][63][64][65][66][67][68][69] In addition, there were 12 studies that compared KP with international health care systems. 55,58,62,63,[70][71][72][73][74][75][76][77] Among the different topical areas that the comparative health systems studies covered, the most frequently studied topic was quality of care (n = 30) a and articles that related to health information technology/EHR/clinical decision support/telemedicine (n = 18). b Other commonly studied topics included resource use (cost/utilization; n = 16), c health systems performance (n = 7), 14,59,61,70,72,73,76 and disease management (n = 7).…”

Comparative Health Systems Research among Kaiser Permanente and Other Integrated Delivery Systems: A Systematic Literature Review

“…Seven studies suggested clinical integration as a possible reason for better performance. 19,27,58,61,62,70,74 The use of technology (ie, electronic alerts, health information technology, EHR, secure messaging, remote video technology) was another common attribute cited across studies. e Last, a comprehensive approach to care delivery (ie, multidisciplinary care teams, comprehensive care management, interdisciplinary treatment, multimodal interventions) and self-management were other themes highlighted as possibly improving patient outcomes.…”

Fast-tracking acute hospital care — from bed crisis to bed crisis

“…19 A recent paper in the British Medical Journal compared and unfavourably contrasted the successful fast-tracking of acute medical care by an insurance-based service run by Kaiser Permanente in California with the slower pace of Medicare and NHS patients. 20 A key conclusion was that better use of scarce resources and economic benefit could be gained in NHS hospitals by fast-tracking acute medical patients. The cost savings made by the reorganisation of the acute medical service at Dunedin support that conclusion.…”