Length of hospital stay for elderly people is substantially higher in the NHS compared with Kaiser Permanente and US Medicare programmes

Question. Does utilization of hospital beds by people aged over 65 years differ in the NHS in England, Kaiser Permanente in California and Medicare in California and the USA? Study Design. Retrospective cohort study. Main results. For all 11 causes of hospital admissions, standardised length of hospital stay for people aged >65 years was highest in the NHS (3.5 times as long as Kaiser, twice as long as Medicare California, and nearly 50% higher than Medicare in the United States). Standardised hospital admission rates for 11 leading causes of hospital admissions in people aged >65 years are generally highest for Medicare recipients in the United States and California, followed by the NHS in England and then Kaiser Permanente in California (see Table 1). However, there are important limitations to the reliability of these findings (see notes). Authors' conclusions. For 11 leading causes of acute hospital admissions in people aged >65 years, the NHS has generally lower hospital admission rates and longer hospital stays compared with Medicare recipients in the United States and California, and Kaiser Permanente in California. A table is presented.