Abstract:
OBJECTIVE:To determine how the UK National Health Service (NHS) is performing relative to health systems of other high income countries, given that it is facing sustained financial pressure, increasing levels of demand, and cuts to social care. DESIGN:Observational study using secondary data from key international organisations such as Eurostat and the Organization for Economic Cooperation and Development. SETTING:Healthcare systems of the UK and nine high income comparator countries: Australia, Canada, Denmark, France, Germany, the Netherlands, Sweden, Switzerland, and the US. MAIN OUTCOME MEASURES:79 indicators across seven domains: population and healthcare coverage, healthcare and social spending, structural capacity, utilisation, access to care, quality of care, and population health. RESULTS:The UK spent the least per capita on healthcare in 2017 compared with all other countries studied (UK $3825 (£2972; €3392); mean $5700), and spending was growing at slightly lower levels (0.02% of gross domestic product in the previous four years, compared with a mean of 0.07%). The UK had the lowest rates of unmet need and among the lowest numbers of doctors and nurses per capita, despite having average levels of utilisation (number of hospital admissions). The UK had slightly below average life expectancy (81.3 years compared with a mean of 81.7) and cancer survival, including breast, cervical, colon, and rectal cancer. Although several health service outcomes were poor, such as postoperative sepsis after abdominal surgery (UK 2454 per 100 000 discharges; mean 2058 per 100 000 discharges), 30 day mortality for acute myocardial infarction (UK 7.1%; mean 5.5%), and ischaemic stroke (UK 9.6%; mean 6.6%), the UK achieved lower than average rates of postoperative deep venous thrombosis after joint surgery and fewer healthcare associated infections. CONCLUSIONS:The NHS showed pockets of good performance, including in health service outcomes, but spending, patient safety, and population health were all below average to average at best. Taken together, these results suggest that if the NHS wants to achieve comparable health outcomes at a time of growing demographic pressure, it may need to spend more to increase the supply of labour and long term care and reduce the declining trend in social spending to match levels of comparator countries.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Papanicolas I,Mossialos E,Gundersen A,Woskie L,Jha AKdoi
10.1136/bmj.l6326subject
Has Abstractpub_date
2019-11-27 00:00:00pages
l6326eissn
0959-8138issn
1756-1833journal_volume
367pub_type
杂志文章abstract::This paper examines the impact of marital status on maternal mortality in the period before and the period after German reunification in the area covered by the former East Germany. Maternal mortality ratio prior to the reunification was stable and declined after reunification. This can be attributed to the adoption ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.319.7217.1104
更新日期:1999-10-23 00:00:00
abstract:OBJECTIVES: To determine whether late mortality after sepsis is driven predominantly by pre-existing comorbid disease or is the result of sepsis itself. DEIGN: Observational cohort study. SETTING: US Health and Retirement Study. PARTICIPANTS: 960 patients aged ≥65 (1998-2010) with fee-for-service Medicare coverage w...
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:BMJ (Clinical research ed.)
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abstract:OBJECTIVES:To investigate the effect of Chlamydia pneumoniae infection on future development of ischaemic heart disease and mortality. DESIGN:Prospective longitudinal study. SETTING:Caerphilly, South Wales. SUBJECTS:Plasma specimens were collected during 1979-83 from 1773 men aged 45-59 years. These were tested for ...
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doi:10.1136/bmj.297.6663.1574
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abstract:OBJECTIVE:To determine cancer morbidity in members of the armed forces who took part in tests of chemical warfare agents from 1941 to 1989. DESIGN:Historical cohort study, with cohort members followed up to December 2004. DATA SOURCE:Archive of UK government research facility at Porton Down, UK military personnel rec...
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更新日期:1999-01-09 00:00:00
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更新日期:1992-02-01 00:00:00
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pub_type: 评论,杂志文章
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更新日期:2019-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.307.6909.891
更新日期:1993-10-09 00:00:00
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pub_type: 杂志文章
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更新日期:2012-12-14 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.330.7495.825
更新日期:2005-04-09 00:00:00
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pub_type: 杂志文章
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更新日期:1995-03-04 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2010-07-06 00:00:00
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更新日期:2017-08-17 00:00:00
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更新日期:2012-12-04 00:00:00
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更新日期:2009-11-12 00:00:00
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更新日期:2006-04-29 00:00:00
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