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Kaiser outperforms the NHS
Kaiser Permanente, a Californian non-profit
health maintenance organisation, has costs similar to those of the NHS but
performsconsiderably better. This finding emerges from a detailed
studyof the costs and performance of the two systems (p 135).
Feachemand colleagues adjusted costs to allow for differences in
thepopulation served and other factors, and compared performanceby using multiple criteria. Kaiser members have faster accessto
consultant and hospital services, possibly because Kaiser savesresources
by having only a third of the NHS's hospital utilisationrate (bed
days per 1000 per year). The authors attribute Kaiser'sbetter
performance to better integration of all the elements ofthe system,
management of hospital utilisation, competition, andgreater
investment in information technology.
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