3rd July, 2008, London
Among the hundreds of thousands of words written about different health systems (and I confess that I can account for quite a few thousand alone) there is remarkably little describing what health professionals in different countries actually do. Although we have statistics on how long patients stay in hospital (themselves increasingly meaningless in a world dominated by ambulatory care), we know very little about what happens when a patient with a common medical or surgical problem comes into a hospital. Well, we know what happens in our own country but unless we engage in participant observation, either as health professionals or as patients, in a hospital in another country, we know almost nothing about how things are done elsewhere. Yet without this crucial information, it is difficult to see how we can say anything meaningful about how different health systems perform.
This was what prompted the organisation of a meeting by the NHS Confederation and the European Observatory that brought together health professionals from countries such as Sweden, Finland, France, Germany and Italy to talk through a series of scenarios such as acute myocardial infarction and deep venous thrombosis. As expected, there were many similarities in how patients are managed but also quite a few differences, reflecting the organisation of care in each country. In particular there were differences in the extent to which care was centralised in specialised hospitals or dispersed, in the roles of different health professionals, and the extent to which quality of care was monitored. This is only the beginning of what will be a long process. We will next be using this approach to understand the delivery of child health services at a workshop at the EUPHA conference in Lisbon in November. I hope anyone that is interested in these issues will join us there.