And who is surprised at this?

Death rates in NHS hospitals are among the highest in the western world, shock figures revealed yesterday.

British patients were found to be almost 50 per cent more likely to die from poor care than those in America.

They have five times the chance of dying from pneumonia and twice the chance of being killed by blood poisoning.

Experts say that, despite recent improvements, NHS death rates still outstrip those in many other European countries.

We’ve long known that the NHS is bad, low in the rankings, of mortality amenable to health care.

15 comments on “And who is surprised at this?

  1. Death rates are screwed up by practise differences between countries. In Germany they will hospitalise you with a sniffle. In England you have to be half-dead already before they let you in. I don’t think you can “adjust” for that.

    Not arguing with the conclusion though.

  2. James (and obviously ignore this if you have neither the time nor inclination) – how is the German system paid for?

  3. hmm, normally Tim jumps all over methodology and appropriate comparability in stories like this. Why not this one?

  4. @JamesV: so I suppose you think that Jarman just added up the number of people who died in hospital, and divided by the number admitted, and compared countries? Don’t be so stupid. The rates are calculated to take into account age and severity of illness. So if the Germans admit loads of people with the flu, who don’t die, it has zero effect on the death rate for admission with heart disease (for example).

    You can try and pretend that the Wonder of the World ™ isn’t actually killing tens, if not hundreds, of thousands of its patients, compared to other national health systems, but unfortunately the evidence is stacking up to the contrary.

  5. @Interested, 80 to 90% of Germans are in a mandatory public health insurance scheme. There’s about 200 of these (used to be more) and they used to be able to charge (very) different rates to their customers. Until a few years ago when the fees (a proportion of your salary, capped at around €4000 a month) were all levelled out and dictated by government. Those without salaries are basically covered by the premiums paid by those with salaries – it’s complicated, for example dependents of salary-earners are treated differently to those on welfare, but basically everyone gets cover somehow and those with income pay for it.

    The law was named, entirely without irony, “a law to strengthen competition in the public health insurance system”.

    There are occasional scandals with the public insurers trying to offload unprofitable customers. They always used to end up on the “AOK” insurance, who would take anyone and charged accordingly (especially seeing as many of their customers had no income anyway).

    Almost everyone else is privately insured (and obliged to be so). Only a tiny number of people are not insured, having fallen through some loophole in the law or unable to pay their premiums. Notably if you choose to go private (and you can only do so if you are earning a “high” salary, roughly €4000 a month or above) it is nearly impossible to get back in the public insurance system.

  6. @Jim, data adjustment is a whole pile of stinking useless fucking occult bullshit and underlies most of the total crap you come across in science these days. Those who don’t like it in climate research should not seek to defend it when it is used in other areas and happens to result in conclusions they have already reached.

    The best you can really hope to do and produce realistic numbers is stratification. Again that isn’t perfect but it’s better, the principal disadvantage to the propagandist being that you cannot then come up with a single number that gives you a shock headline and neat soundbite.

    I don’t know how this “research” was done so I could be defaming the author, however the press is talking about adjustment.

  7. Those who indulge in data adjustment are basically claiming to know the relative magnitude of all of the effects they are attempting to measure in the first place. It is quite staggering the chutzpah with which it is deployed these days.

  8. Tim: if “mortality amenable to healthcare” is your preferred measure, you should be aware that it’s substantially higher in the USA than in the UK.

    The reality is that this measure depends on a lot more than the quality of acute care. For example, it’s usual to count 50% of deaths before 75 from ischaemic heart disease as being amenable to healthcare. Now, Mediterranean countries – France, Spain, Italy – have low mortality from IHD. It’s around the OECD average in the UK and Germany, and well above it in the USA. And, IHD being a major cause of death, this correlates very well with the rankings of those countries by mortality amenable to healthcare.

    Do you think that mortality from ischaemic heart disease in Spain is about half that in the USA because its healthcare system is twice as good? If not, you should stop using this statistic to bash the NHS.

  9. Mortality amenable to healthcare is just another invented statistic in that case. It’s like the regular NHS statistics on admissions related to alcohol, when they count n% of admissions with head injuries as alcohol-related, on the basis of some audit conducted years ago. You don’t think they actually note the cause of each presenting head injury in some great NSA database?

    Rather a lot of mortality is amenable to health care, even mundane stuff just for happening in the wrong place. If you have a massive heart attack in the wilds of Montana you are in somewhat more trouble than if you have it on 34th Street in Manhattan. That doesn’t mean we should have a specialist heart unit on standby in the wilds of Montana. Sure ideally we would have one, but the costs are such that the money is better spent elsewhere. But it’s still a death amenable to healthcare, and might have had a non-death outcome on 34th Street rather than supply of a body bag with no admission to contribute as 0.7% of an admission on the admissions considered related to alcohol.

  10. Quibbles about Manhattan traffic and the relative lack of helicopter ambulance landing spaces aside, of course.

  11. “If not, you should stop using this statistic to bash the NHS.”

    It’s not just Tim – it’s large swathes of the media, politicos of all stripes, the blogging commentariat, ConHome, etc etc. Not helped by Sec Chunt using such stories as a means of justifying his pisspoor reforms – the irony being that said reforms are making things at the coalface good deal worse (e.g. witness the chaos as the minions of DoH/Monitor try to enforce ‘competition’).

  12. It seems to me the article is talking about the clinical care after admission to a hospital when it states “more likely to die from poor care.”

    I suppose the article may not cite the statistics accurately, although the quote attributed to Professor Jarman suggests the article is accurate.

    Also – assuming the article is accurate – I think it’s evading the issue to suggest that the finding it reports is somehow not valid grounds to express criticism of the NHS.

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