Saturday 19 January 2002
No 7330 Volume 324
Please remember to credit the BMJ as source when publicising
an
article and to tell your readers that they can read its full text on
the
journal's web site (http://bmj.com).
If your story is posted on a website please include a link back to
the source BMJ article (URL's are given under titles).
(1) U.S. PATIENTS GET MORE FOR THEIR
MONEY THAN NHS PATIENTS DO
(2) HERBAL
EXTRACT IS AN EFFECTIVE
TREATMENT FOR
HAY FEVER
(3) DEPRESSION
AFTER UNINTENDED
PREGNANCY IS
LINKED TO ABORTION
(1) U.S. PATIENTS
GET MORE FOR THEIR
MONEY THAN NHS PATIENTS DO
(Getting more for their dollar: a
comparison of the
UK's NHS with California's Kaiser
Permanente)
http://bmj.com/cgi/content/full/324/7330/135
Some patients in the United States are
getting better
health care than NHS patients in Britain,
for roughly
the same cost, finds a study in this week's
BMJ.
Richard Feachem and colleagues compare
the costs
and performance of the NHS with those
of Kaiser
Permanente, a non-profit health organisation
in
California, with 6.1 million members.
Kaiser was
chosen because it represents an integrated,
NHS-like organisation, providing a similar
range of
services to the NHS.
After adjusting for age and socio-economic
differences between the two populations,
they found
that although the health care costs per
capita in
Kaiser and the NHS were similar to within
10%,
Kaiser's performance was significantly
better in
several important areas.
For example, Kaiser patients have access
to
significantly more specialists than NHS
patients, and
spend one third of the time in hospital
than NHS
patients do. Waiting times to see a specialist
are
over three times as long in the NHS.
Reasons why Kaiser can achieve better
performance at roughly the same cost as
the NHS
include better integration of care; treatment
of
patients at the most cost effective level
of care; the
benefits of competition; and better information
technology, suggest the authors.
The widely held beliefs that the NHS is
efficient,
and that poor performance in certain areas
is largely
explained by under investment, are not
supported
by this analysis, say the authors. Kaiser
is certainly
not a perfect system, and has its share
of critics in
the US. However, these findings point
to the value
that can be gained from comparing health
care
systems. "It is our hope that they will
encourage
further analysis and policy debate," they
conclude.
Contact:
Emma Wilkinson, British Medical Association
Press
Office, BMA House, Tavistock Square, London,
UK
Email: ewilkinson{at}bma.org.uk
(2) HERBAL EXTRACT
IS AN EFFECTIVE
TREATMENT FOR HAY FEVER
(Randomised controlled trial of butterbur
and
cetirizine for treating seasonal
allergic rhinitis)
http://bmj.com/cgi/content/full/324/7330/144
The herbal extract, butterbur, is as effective
as
antihistamines for treating hay fever,
and does not
have the sedative effects often associated
with these
drugs, finds a study in this week's BMJ.
Researchers in Switzerland identified 125
patients
with a history of hay fever. Patients
received either
butterbur extract tablets or a commonly
used
non-sedating antihistamine (cetirizine)
as
recommended by the manufacturers.
After two weeks, the effects of butterbur
and
cetirizine were similar in the two treatment
groups.
Cetirizine produced more sedative effects
(drowsiness and fatigue) than butterbur,
despite the
drug being considered a non-sedating antihistamine.
"We believe butterbur should be considered
for
treating hay fever, particularly in cases
where the
sedative effects of antihistamines need
to be
avoided," conclude the authors.
Contact:
British Medical Association Press Office,
BMA
House, Tavistock Square, London, UK
Email: pressoffice{at}bma.org.uk
(3) DEPRESSION
AFTER UNINTENDED
PREGNANCY IS LINKED TO ABORTION
(Depression and unintended pregnancy
in the
National Longitudinal Survey of
Youth: a cohort
study)
http://bmj.com/cgi/content/full/324/7330/151
Depression among women after an unintended
first
pregnancy is linked to whether they abort
or carry
to term, conclude researchers from the
United
States, in this week's BMJ.
Data from a national study of American
youths,
begun in 1979, was used to conduct the
research.
In 1992, a subset of 4,463 women were
surveyed
about depression and unintended pregnancy.
A total of 421 women had had their first
abortion or
first unintended delivery between 1980
and 1992.
Among married women, those with a history
of
abortion were significantly more likely
to be at high
risk of clinical depression compared with
those who
delivered unintended pregnancies.
Among unmarried women, rates of high risk
depression were similar, regardless of
whether they
aborted or carried to term. This may be
due to the
stress unmarried women may experience
in raising a
child without support or it may be related
to this
group's higher rate of concealing past
abortions,
suggest the authors.
Compared with national averages, unmarried
women in this study report only 30% of
the
expected abortions compared with married
women,
who report 74% of the expected abortions,
which
may make the results for married women
more
reliable, say the authors.
Since shame, secrecy, and thought suppression
regarding an abortion are all associated
with greater
post-abortion depression, anxiety, and
hostility, the
high rate of concealing past abortions
in this group
(60% overall), means that these results
may
underrepresent the full effect of abortion
on
subsequent depression, they conclude.
Contact:
David Reardon, Director of Research, Elliot
Institute, Springfield, Illinois, USA
Email: dcr{at}mine4ever.net
FOR ACCREDITED JOURNALISTS
Embargoed press releases and articles are available from:
Public Affairs Division
BMA House
Tavistock Square
London WC1H 9JR
(contact: pressoffice{at}bma.org.uk)
and from:
the EurekAlert website, run by the American Association for the
Advancement of Science
(http://www.eurekalert.org)
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