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[Hoo-doo]

Way to compare two completely different systems with a stat that has no meaning in the real world.

Compare complication/mortality rates of surgeries or something.

 

[Kinyou]

People with money come from around the world to the US for their medical care, US is BY FAR AND AWAY the best place in the world for care

Afaik does the US have the best doctors. Not the best hospitals. And the US isn't the only country that has lots of international patients.

In W.H.O studies the US ranks pretty low.

 

[kirblar]

So why's he saying that too many are dying when people expect them to go home? I don't think his point was that people have unrealistic expectations or that it's because they keep them in house rather than sending them to hospices.

Correct. Hospitals are dangerous for immune-compromised people because there's a high risk of them getting piggyback infections on top of whatever problem they already have. Finding ways to reduce this in the system is a big deal.

 

[Necromanti]

The number of deaths that occur in a hospital setting seems like such an odd metric to use and devoid of any meaning other than as a talking point about the dangers of socialized medicine.

And some have done studies into evaluating the flaws of using such a methodology.

Even then, it says nothing about the "dangers of socialized medicine" because they compared the NHS to the healthcare system of seven other countries, with the UK's death rates being starkly higher relative to the rest. I am pretty sure that some of the other countries used for the comparison employ socialized medicine. It would be nice to actually see the data firsthand, though.

 

[fallagin]

Seems to me like this might have something to do with dying people seeking medical attention more often in the uk.

 

[SamVimes]

Way to compare two completely different systems with a stat that has no meaning in the real world.

Compare complication/mortality rates of surgeries or something.

And even then it wouldn't be really accurate. If you need to go through a really expensive procedure that grants really low chance of living it's more likely you'll do it in a country with free health care than in the US.

 

[JesseEwiak]

To be fair, you could probably make some comparisons between a hospital in East LA or Miami and the Mayo Clinic and the hospitals in LA or Miami wouldn't come out too good either.

A better comparison would be an average hospital in the UK and an average hospital in the US.

 

[CyclopsRock]

The article compares UK to US, why? Because they can't compare it to say, France or Canada, with similar systems to us? What is the one main reason there's a difference, the one the article only mentions in passing? The tactic of running down a service until the public welcome any change worked for virtually all the other public services that have been sold off, so I remain skeptical. The comparison between the NHS and one clinic in the US raises more questions than it answers, and it handily doesn't offer a solution. The idea that they have it better over there is good enough, the idea that it's shit now is good enough. The path is a well trodden one unfortunately.

The article points to Mid Staffs as an example of what happens when complaints aren't taken seriously and it's mentioned that particularly bad hospitals pull down the average. Mid Staffs happened at a time when the NHS had more money at its disposable than ever before. The "one main reason" is not the cause of things like Mid Staffs, which is far more about the culture of that particular hospital. Even if France and Canada, patients have far greater control over their care than in the UK, which leads to the lack of accountability that the article refers to.

 

[Giygas AF]

The elderly figure is interesting. Obviously the elderly are a huge drain on socialized medicine. I wonder if the hospitals in the UK see them as a walking liability and don't give them outstanding care where in the USA they are seen as a walking payday and are given every opportunity to extend life. I know when my grandmother was extremely ill she was getting phenomena on a seemingly bi-weekly basis and in the hospital all the time.

I kind of have mixed feelings about this. I once saw a study (can't remember where maybe on news so don't take it to heart) saying that around 70% of healthcare costs of an individual are spent during their elderly year or 2 years before they die. The study was to show that young people generally didn't need the same kind of coverage as the elderly and they could get away with high deductibles. If this is true though, I can see old people being walking banks, and the government probably doesn't want to pay all that since they are going to pass away anyway.

 

[Whitechocolatekrispies]

Our hospitals are open to all the scum of society.

American top hospital is open only to the wealthy rich.

The fact the US hospital is only 45% more likely to keep someone alive is embarrasing.

Now which hospital provides better care, cleaner rooms, better attention and better doctors ...

US hospitals.

 

[Deleted member 13876]

You get what you pay for

Before making gut claims like that can we see the numbers for other countries with national healthcare.

 

[Dr.Acula]

The article compares UK to US, why? Because they can't compare it to say, France or Canada, with similar systems to us? What is the one main reason there's a difference, the one the article only mentions in passing? The tactic of running down a service until the public welcome any change worked for virtually all the other public services that have been sold off, so I remain skeptical. The comparison between the NHS and one clinic in the US raises more questions than it answers, and it handily doesn't offer a solution. The idea that they have it better over there is good enough, the idea that it's shit now is good enough. The path is a well trodden one unfortunately.

True, it seems like it's trying to sell an angle. I love how they point out "piano music" and "sunlight streaming through the lobby" in America. I hear the streets are paved with gold, too! There's a lot of money to be made in private health care, and there are a lot of carpetbaggers going after water, electricity, security, and other public sectors, all trying to get rich off the huge bases formed over the decades by public delivery.

 

[GaimeGuy]

To be fair, you could probably make some comparisons between a hospital in East LA or Miami and the Mayo Clinic and the hospitals in LA or Miami wouldn't come out too good either.

A better comparison would be an average hospital in the UK and an average hospital in the US.

This too.

The Mayo Clinic is one of the top 2 or 3 hospitals in the country.

 

[Randdalf]

Of course, that was nearly 10 years ago

So this is based on data that is 10 years old?

 

[Bulbo Urethral Baggins]

This is what happens when equity is your goal rather than quality of care. Equally shitty.

 

[GaimeGuy]

Oh look it's bulbo.

You know what's shitty? Paying 500 bucks as a copay for a scrotal ultrasound after having to call the doctor's office 4 times until they'd get you in for one sooner than 6-8 weeks out.


That's the american way. I'll take the NHS any day over our shitty country's system. Would save me at least 2 or 3 grand a year to have my taxes raised 3-5% to pay for shit instead of having the insurance companies rape my wallet and that of my employer.

 

[ToxicAdam]

Seems like a simple fix for the NHS. Hire more people.

 

[Maledict]

There is a huge and pressing issue regarding the Elderly in NHS hospitals. Basically far too many people end up staying in hospital longer than they should, and indeed for the remainder of their lives, because there isn't the required social care available for them outside of hospitals. It is a pressing issue for most areas of the country - because the NHS is free, people go to hospital when unwell, but as social care often isn't or there's a lack of the required care, people then end up staying in hospitals when they shouldn't.

In essence the are entire wards which are end of life care homes for all intents and purposes. They shouldn't be, but that's what happens due to the system outside of the NHS.

We have a huge issue with social care for the elderly in this country,and I think these numbers are just another horrific side effect of that by pushing the burden onto the wrong agency.

 

[Wilsongt]

Pack it up. Republicans were right.

 

[daviyoung]

The article points to Mid Staffs as an example of what happens when complaints aren't taken seriously and it's mentioned that particularly bad hospitals pull down the average. Mid Staffs happened at a time when the NHS had more money at its disposable than ever before. The "one main reason" is not the cause of things like Mid Staffs, which is far more about the culture of that particular hospital. Even if France and Canada, patients have far greater control over their care than in the UK, which leads to the lack of accountability that the article refers to.

While I'll remain keen-eyed on what our government have in store for our greatest public services, I think my ire is better spent on the quality of the article in this case.

 

[ksan]

What a useless piece of shit article, it basically says nothing of interest.

 

[SquiddyCracker]

Makes sense.
You're going to have more sick and near-death individuals seek out medical attention in the UK rather than the US.

Primary example are the elderly.
I'm sure more of them die in hospitals in the UK versus the US, and that would increase the numbers of total hospital deaths.

 

[Funky Papa]

What is the proportion of elderly people living in retirement homes at both countries?

While I can't speak of the UK, I know that retirement homes are very popular in America, whereas in much of Europe old people live by themselves or share their home with a close relative. IE: my own grandparents live alone, but their kids take turns to tend them, meaning that if they feel poorly, they are going to be taken to the hospital with the quickness (and for many old folks, that's the end of it).

This article is rather misleading.

 

[avaya]

How did they control for people being more likely to seek out free health care?

They didn't.

 

[Race to be King]

Our hospitals are open to all the scum of society.

You sound like a thoroughly pleasant and rational person who I would love to be sat next to at a dinner party.

 

[Prez]

Maybe more people die outside hospitals in the US.

 

[WARCOCK]

in the us 45% of patients can't afford to die in a hospital!

On a more serious note, care cannot be refused in most "public"/university hospitals and i'm curious if the patient is near terminal and spends a certain amount of days in the hospital is the cost/debt incurred to children or relatives if the patient is not covered under medicare or private insurance?

 

[DJ_Lae]

This is interesting although I'd have to read up more on it. I essentially do the same thing on an annual basis for my job, though I focus both on costs and on performance (where it can be measured at least).

Interestingly, at no point have we (here in Canada) used the UK as comparison, and now I'm very curious why. I wonder if something causes an issue with direct comparisons.

Off the top of my head I know the US does have a lower life expectancy than most developed countries, and the WHO's health-adjusted life expectancy is similarly bleak. I wish they still produced that metric, actually, it's a good way to compare quality of life from country to country though I understand why they stopped (it's a pain in the ass to generate).

 

[Inversive]

What a bias trash article, it doesn't take into account all the unhealthy humans in America that can't even afford to go and die in a nice Hospital where as in the UK it is free for everyone.

 

[Madness]

As someone who's used both Canadian and American hospitals/health care, give me the US anyday.

If you have insurance, there is no better medical treatment.

Plus, it's not even that Canadian healthcare is free either, you still have to pay to have better coverage.

Had to wait 5 months for an MRI for my knee in BC, something that was done in two days in Washington state.

 

[akira28]

This is what happens when equity is your goal rather than quality of care. Equally shitty.

Agreed. Go for both. Not sinking all boats to the same low level. Equal access to high quality care.

 

[solarus]

My experience with the NHS has been excellent but I guess it depends where you live.
EDIT: Also this thread is going to be full of americans who have no idea what the fuck they are talking about.

 

[Enco]

Seems like a simple fix for the NHS. Hire more people.

Hiring more people would be fucking amazing.

Where's the money going to come from though?

 

[daviyoung]

Hiring more people would be fucking amazing.

Where's the money going to come from though?

That's the joke

 

[Shambles]

Yes, when you have to mortgage your home to get treatment people tend to die at home instead of the hospital more often.

 

[xbhaskarx]

You get what you pay for

.

 

[Kurtofan]

How many sick Americans die outside hospitals though?

 

[Bleepey]

Did the researchers would account for recruitment bias? By this i mean did they account for the fact the sick and poor may go to hospitals for treatment whilst in the US healthcare system may mostly consist of the rich.

 

[Little Green Yoda]

How did they control for people being more likely to seek out free health care?

People with free health care should, in theory, be healthier overall since they could afford preventative medicine.

But yeah, using hospital mortality alone seems like a poor metric. Especially if you're using the fucking Mayo Clinic as an example.

 

[dantevsninjas]

I imagine some of that gulf would be made up by factoring in those in this country that can't afford healthcare. You know, the ones who's best choice for dying with a little dignity is crawling behind the couch.

 

[Zoe]

Way to compare two completely different systems with a stat that has no meaning in the real world.

Compare complication/mortality rates of surgeries or something.

It doesn't sound like a simple check in a column whether someone lived or died.

The data is the work of Professor Sir Brian Jarman, who pioneered the use of hospital standardised mortality ratios (HSMRs), as a way of measuring whether death rates are higher or lower than expected and which are adjusted for factors such as age and the severity of the illness.

 

[ksan]

It doesn't sound like a simple check in a column whether someone lived or died.

Doesn't matter when you have such selection bias, if they only came up with the results presented in the article, the research was practically worthless.

 

[GJS]

Key weaknesses in the HSMR system included:

- That it only measures certain sets of deaths, not all deaths.

- That it ignores deaths that happen just after discharge from hospital so that, perversely, a hospital could improve its HSMR scores by sending seriously-ill patients home early to die, or will have better HSMRs if it has a lot of hospices nearby to take patients for their last days or weeks.
- That it is dependent on the ‘Payment by Results’ data reported by hospitals for financial purposes. This data is often seriously incomplete. Dr Foster, the company behind HSMRs, offers no training or auditing to ensure that the ‘coding’, the recording of the full range of conditions from which a deceased person suffered, is done correctly. This means that a hospital can suffer from having poor coders (a frequently-cut area for cost-savings), or simply because it reports its deaths more honestly than average.

It all depends on junior doctors filling in coding details (not gonna happen), or clinical coders who's sole job is to enter details in regards to the original admission and the death. Something like 30%+ of them are inaccurate.

One of the key weaknesses with the HSMR system is that it is based around a ‘standard’ score of 100 – which is ‘rebased‘ every year. In simple terms, the statistics take an average score for all the hospitals in England and call that ’100′. Hospitals scoring worse than average get a score above 100, while hospitals scoring better get below 100

Year by year the HSMRs values increase based upon the previous years results. There is no set standard that they should be aiming towards per hospital, it just says deaths are higher than expected based upon previous results. If everyone is getting higher than expected deaths, that becomes the average the next year, which is then the base line for the following year, and any subsequent higher than expected deaths can't really be compared directly to previous years.


Specialist or Tertiary hospitals and patient populations also still skew HSMR results.

 

[xenist]

I see Cameron's boys are hard at work trying to bring up the NHS to the standards of his spiritual home. Are they also using the same PR agency Blair used to sell Iraq 2?

 

[Vane_MagicCity]

Well, in the US if you are poor then you can't afford to die in a hospital. In fact, you probably didn't get much in the way of health care leading up to death. I wonder how many of the 99% are too poor to get health care in the US.

 

[Ruuppa]

Silly article. Let's compare these two figures to each other without taking anything else, like the grand total of patients treated or money spent on the healthcare system or something, into consideration and jump to conclusions.

 

[J-Rod]

This feels like a repeat of the hidden camera thread in the way people are choosing to interpret it.

The elderly in the US have socialized medical insurance.

 

[RedShift]

Lol, lies, damn lies and statistics.

The difference is one is free and one is not.

The worry with the NHS is we only compare it to the US system which is obviously inferior. We do need to accept it needs reform and improvement, but we won't get it by comparing it to that shit show.

 

[diehard]

Had to wait 5 months for an MRI for my knee in BC, something that was done in two days in Washington state.

Holy shit 5 months?

 

[Cyan]

I can't help but point out that elderly dying people are way more likely to be in a Hospital in the UK than in the US.

It just seems like a really weird metric to judge performance on.

My first thought too. I'll be interested to see more data.