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Biomedical subjects

Chris Ham

Publications and source records attributed to Chris Ham.

At least 19 recordsLinked to original sources
PubMed2006

Staying Power.

A U.S. firm's pioneering approach to healthcare for older patients has produced lower admission rates and shorter stays than equivalent care in the NHS. The firm's approach involves closer integration between primary and secondary care. Pilot sites in the U.K. show the importance of integration across sectors and into the community.

Efficiency, Organizational↗
PubMed2003

Hospital bed utilisation in the NHS, Kaiser Permanente, and the US Medicare programme: analysis of routine data.

OBJECTIVE: To compare the utilisation of hospital beds in the NHS in England, Kaiser Permanente in California, and the Medicare programme in the United States and California. DESIGN: Analysis of routinely available data from 2000 and 2001 on inpatient admissions, lengths of stay, and bed days in populations aged over 65 for 11 leading causes of use of acute beds. SETTING: Comparison of NHS data with data from Kaiser Permanente in California and the Medicare programme in California and the United States; interviews with Kaiser Permanente staff and visits to Kaiser facilities. RESULTS: Bed day use in the NHS for the 11 leading causes is three and a half times that of Kaiser's standardised rate, almost twice that of the Medicare California's standardised rate, and more than 50% higher than the standardised rate in Medicare in the United States. Kaiser achieves these results through a combination of low admission rates and relatively short stays. The lower use of bed days in Medicare in California compared with Medicare in the United States suggests there is a "California effect" as well as a "Kaiser effect" in hospital utilisation. CONCLUSION: The NHS can learn from Kaiser's integrated approach, the focus on chronic diseases and their effective management, the emphasis placed on self care, the role of intermediate care, and the leadership provided by doctors in developing and supporting this model of care.

Aged↗
PubMed2003

Booking patients for hospital admissions: evaluation of a pilot programme for day cases.

PROBLEM: NHS patients requiring elective surgery usually have to wait before being treated and are usually told when a date becomes available. DESIGN: 18 month pilot programme to enable day case patients to book date of hospital admission at time of decision to operate. BACKGROUND AND SETTING: 24 pilot sites in England with relatively short waiting times and some experience of booking appointments. KEY MEASURES FOR IMPROVEMENT: Proportion of patients with booked or "to come in" date during and after pilot programme, proportion not attending for admission, and proportion waiting > or = 6 months. Comparison of pilot sites with non-pilot sites. STRATEGIES FOR CHANGE: National Patients' Access Team established to help pilot sites enable patients to book admission dates. Provision of 9.9m pounds sterling to pilot sites to employ project managers, purchase equipment, buy extra time from clinical and other staff, and invest in information and communications technology. EFFECTS OF CHANGE: Proportion of patients with booked or "to come in" date increased from 51.1% to 72.7% between end of March 1999 and end of March 2000, and then fell to 66.2% by end of March 2001. Over the same periods, the proportion of patients waiting > or = 6 months fell from 10.9% to 10.5% and then increased to 11.9%. The proportion of patients failing to attend fell from 5.7% to 3.1% between the first quarter of 1999 and the first quarter of 2000, and then increased to 4.0% in the first quarter of 2001. Pilot sites varied widely in performance during and after the pilot phase. Pilot sites had higher proportions of patients with booked or "to come in" date than non-pilot sites at end of each period. LESSONS LEARNT: Increasing the proportion of patients who book their date of hospital admission is possible, but there are difficulties in sustaining this. Several factors facilitated or hindered the implementation of booking, and the roll out of the programme across the NHS is seeking to incorporate these factors.

Day Care, Medical↗