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Figure 11

Average Length of Hospital Stay

9.6

7.1

6.4

6.2

6.2

5.4

Germany

Canada

OECD

U.K.

Aus tralia

U.S.

Median

Source: Gerard F. Anderson, Uwe E. Reinhardt, Peter S. Hussey, and Varduhi Petrosyan, “It’s the Prices, Stupid: Why

the United States Is So Different from Other Countries,” Health Affairs 22, no. 3 (May/June 2003): 97, Exhibit 5.

Many public health officials think the actual

and one half times as many pediatricians, twice

Minorities

number may be far higher. Liam Fox, admit-

as many obstetricians-gynecologists, and three

are often

tedly the British Conservative Party's shadow

times as many cardiologists per enrollee as the

discriminated

health secretary and thus a Labor government

NHS. After referral, waiting times to see a spe-

critic, has estimated that the true number of

cialist were more than six times as long in the

against under

blocked beds is closer to 15 percent.64

NHS. For nonemergency hospital admission,

national health

90 percent of Kaiser patients waited less than

The statistics on bed utilization indicate

insurance.

three months; one-third of NHS patients wait-

bed management in Britain is highly ineffi-

ed more than five months.

cient. More than one million people are wait-

One of the most striking differences

ing for medical treatment in British hospitals

between the two health systems was the

at any one time, and an estimated 500,000

length of stay. Kaiser had 270 acute care bed

surgeries were cancelled in the past five years

days per 1,000 population, whereas NHS

because of the shortage of NHS hospital

beds.65 Yet close to 30,000 beds (16 percent of

patients stayed in the hospital more than

the total) are empty on any given day.66 These

three times as long--an average of 1,000

acute care bed days per 1,000 population.68 In

estimates imply that as many as one out of

three NHS hospital beds is unavailable for

summary, the study found that

acute care patients.

A British Medical Journal comparison of the

The widely held beliefs that the NHS is

British NHS and Kaiser Permanente, a large

efficient and that poor performance in

U.S. health maintenance organization (HMO),

certain areas is largely explained by

concluded that the per capita costs of the two

underinvestment are not supported by

systems were similar. However, the analysis

this analysis. Kaiser achieved better

found that Kaiser provided its members with

performance at roughly the same cost

more comprehensive and convenient primary

as the NHS because of integration

care services and much more rapid access to

throughout the system, efficient man-

specialists and hospital admissions. After

agement of hospital use, the benefits of

adjustments for differences between countries,

competition and greater investment in

information technology.69

the NHS cost was calculated at $1,764 per capi-

ta compared to a Kaiser cost of $1,951.67

However, as Figure 12 shows, Kaiser had two

The Congressional Research Service has

12