Recurring Outbreaks of an Infection Apparently Targeting Immune Function, and Consequent Unprecedented Growth in Medical Admission and Costs in the United Kingdom: A Review

Abstract

Background:The National Health Service (NHS) in the UK has been beset by unprecedented growth in emergency admissions to hospital which are specifically medical in nature, while surgical and trauma admissions are only showing the level of low growth expected from demographic change, or what is called the ageing population. There has never been an adequate explanation for this dichotomy. An Infectious Basis: The proposed infectious basis rests upon the observation that growth in medical admissions occurs in spurts which occur approximately five years apart, albeit three years between spurts have also been observed during the 1990's. It is these spurts which are driving the long-term growth, rather than the relatively minor growth which occurs in the interval between the spurts. These periods of high growth are characterized by spikes in all-cause mortality, and typically result in a 15% increases in admissions to the medical group of specialties. However much higher growth is seen for particular conditions/diagnoses which appear to have a common

The effects of the NHS reforms on quality of care

“…When this point is reached, inevitable trade-offs between quality and cost of care would have to be made however implicit and undesirable this may be (Jones 2011). For example, it is commonly observed that bed occupancy greater than 85% leads to increased risk of hospital acquired infections, serious errors and higher mortality (Jones 2015).…”

“…Bed occupancy greater than 85% is a surrogate marker of reduced staff per patient ratios and is an indicator of a cost efficient but under resourced service (Jones 2011(Jones , 2015(Jones , 2016. Jones et al reported a close correlation between annual Summary Hospital-level Mortality Indicator (SHMI) and inpatient bed occupancy above 85% (Jones 2016).…”

The calendar year fallacy: The danger of reliance on calendar year data in end‐of‐life capacity and financial planning

“…The curious observation is that these saw-tooth features have been identified across the whole of Europe, Australia, New Zealand, and in the counties of Arizona (USA) [36][37][38] and also simultaneously occur for the associated medical hospital admissions arising from the nearness to death effect. [39][40][41][42][43] Figure 2 demonstrated clear saw-tooth patterns for a local authority having a simple population structure.…”

Outbreaks of a presumed infectious pathogen creating on/off switching in deaths

“…The unique feature of these outbreaks is that various measures of morbidity and mortality all rise for a 12-month period before reverting to baseline levels [1][2][3][4][5][6]. These outbreaks can be traced back to the 1950's, but presumably occur prior to this [7]. The effect upon deaths has been documented in the UK, across Europe, Australia, New Zealand, USA [7][8][9][10], and Canada (unpublished), and occurs in sub-local authority small areas [4,11,12].…”

“…These outbreaks can be traced back to the 1950's, but presumably occur prior to this [7]. The effect upon deaths has been documented in the UK, across Europe, Australia, New Zealand, USA [7][8][9][10], and Canada (unpublished), and occurs in sub-local authority small areas [4,11,12]. The simplest way of detecting these unique events is to utilize a running (moving) 12-month total of deaths.…”