Question for those who have national health care

[rolanni]

I have been told that in nations with socialized medicine (my correspondent uses the UK as their example) a person who has broken their hip will wait an average of three months for treatment.

Can anyone tell me if this is so?

Thanks.

Comments

[lagilman]

A friend of mine who is (was) Canadian said that in Canada, he would have waited months to get an MRI that in the States was scheduled for the very next day. So that seems plausible, if painful...

[craig trader (from livejournal.com)]

http://www.swl.hlth.gov.bc.ca/swl/swl_db/swl.WaitlistPkg.GetHospitalListBySurgSpecNLF?IEvent=93.51

Based upon this link, for British Colombia, the wait looks like ~6 months, but depends upon locality.

http://www.va.gov/vatap/pubs/BIB-Waiting-times-for-joint-replacement-surgery-final.pdf

This PDF is a survey of many countries: most countries range from 3 months to 12 months, but Israel can get the job done in 3 days.

[autopope.livejournal.com]

You failed to distinguish between chronic and acute admissions.

My dad went into a (UK, NHS) hospital with a suspected stroke. Time to MRI scan: 48 hours (they needed to stabilize him first).

My wife went into a (UK, NHS) hospital with a persistent migraine. Time to MRI scan: 3 months (after the neurologist ruled out a brain tumor or other emergency requiring instant diagnosis).

From these two data, you could conclude that the NHS takes an average of 6 weeks to carry out needed MRIs ... but the conclusion would be junk because the conflation of an acute/emergency case and a chronic/non-emergency makes for a junk data set.

[autopope.livejournal.com]

It's rubbish.

A broken hip is an acute injury; those get priority treatment (as in, ambulance ride to hospital and immediate admission).

Chronic non-life-threatening conditions are another matter. Things like hip joint operations for osteoarthritis may end up with queues because the emergency stuff gets prioritized.

But waiting three months for a broken hip? Is a scare story intented out of whole cloth, probably by someone with a vested interest in making money out of the US system's inefficiency.

(Sorry. As a sometime ex-NHS worker, this sort of slander -- which is particularly common in US medical circles -- really pisses me off. Not your fault; it just hit one of my hot buttons.)

[papersky.livejournal.com]

I absolutely confirm this.

I broke my hip and pelvis, I had treatment as soon as I said there was something wrong.

I don't think I had to wait for anything -- it was a long time ago, but maybe physio. I've usually had to wait for weeks for physiotherapy.

And if you really had to wait three months with a broken him you'd die, wouldn't you? I mean that's just crazy.

I expect your informant was confusing it with a wait for a hip replacement.

[torrilin.livejournal.com]

Yes, broken hips can and do kill. One of the standard cyclist injuries is "broken hip" which usually turns out to be femur broke in the hip socket. The usual estimates for untreated broken femur are 80% fatal. An actual pelvis fracture can't be a whole lot better for safety.

A hip that needs replacement can also kill, but it takes a *lot* longer. If Mom had waited an extra 3 months for her hip replacement, it might have killed her... but she'd already waited about 1.5 years past the point where a normal person would have had it done, since she was very young for a hip replacement. With how long she waited, she was starting to have bone death, but it was still very early stages.

[adina-atl.livejournal.com]

Can't speak for broken hip, but my brother broke his elbow at 9AM one day and was in surgery to repair it at 9AM the next day, as the surgeon reassembled a three-dimensional jigsaw puzzle with innumerable screws. Self-employed publisher/editor, UK NHS, completely covered. Physio started as soon as he was medically capable, and continued until he decided he had better things to do with his time (his GP keeps telling him they could get more mobility if he'd do more physio).

By contrast, your fellow author Emma Bull's experience (http://morecoffeeem.livejournal.com/1506.html#cutid1), admittedly with two broken elbows.

[adina-atl.livejournal.com]

In more general terms, what the NHS is good at doing promptly is is 1) keeping people healthy, 2) caring for routine illnesses and injuries, and 3) treating emergencies. What they have waiting lists for are 4) advanced medical and surgical treatment of chronic conditions, possibly especially those in advanced age.

1) If you have diabeties, for instance, you will promptly receive necessary education, support, management, and regular appointments--with an emphasis on the education. If you are a child, you will get regular vaccinations and checkups, including eye exams and one free pair of eyeglasses a year if necessary. You can see the dentist every...six months?...for cleaning and exams and whatnot, though some areas of the country have shortages of NHS dentists, I'm told.

2) If you have a sinus infection or your kid has chickenpox, you will be seen the same day by a GP--both my mother and my sister-in-law bear this out, in two different areas of the country. My s-i-l complains when she can't get a same-day appointment with her regular doctor and has to be seen by another doctor in the practice--me, in the U.S., I would be astonished to get a same-day appointment without going to the urgent care clinic.

3) My brother's aforementioned broken elbow, for example. Your example of a broken hip, I suspect.

4) A hip or knee replacement is likely to have a long waiting list, and the medical care isn't likely to be as aggressive as U.S. care (assuming you have insurance, of course, and that your insurance company isn't fighting your doctor and that the surgeon who can do the procedure is covered under your plan and that the deductable isn't more than your budget can handle and that you have transportation to the nearest hospital where the procedure is performed and...).

[painoarvokas.livejournal.com]

As others have said, broken hip is an emergency case and gets treated immediately. I tried to look up current queue waiting times for non-emergency hip surgery here in Finland; and couldn't find any national averages. One set of numbers for a particular region suggested a wait time of a year for non-emergency hip surgery.

[painoarvokas.livejournal.com]

For another data point (not hip related):

I suffered my first prolonged acute cardiac arrhythmia in Janury. My heart felt like it was trying to find its way out of my chest, jumping and twisting all the time. I was conscious and had no trouble to move about, and felt no dizziness or anything like that. I immediately went to the emergency room; I was admitted within five minutes of walking through the front door, and in another five minutes I had been hooked up to the IV and the EKG monitor. In ten minutes I was diagnosed with atrial fibrillation and was given beta blockers intravenously. It did not have any effect, so I was moved to wait for an electric cardioversion.

The thing about atrial fibrillation is that if it goes on for a long time (48 hours is the accepted threshold), there is a significant risk of a stroke and if it goes on untreated for a very very long time, it can weaken the heart. Otherwise, it is an annoying but harmless condition.

16 hours after admission they were ready to perform electric cardioversion (electric shock to the heart to encourage the heart to go back to normal rhythm) to me. I had to wait for others to get the treatment first, since I had gone in early and still had more than a day till the 48 hour deadline. Fortunately, my heart had spontaneously reversed to sinus rhythm.while waiting so I did not receive electric shocks.

16 hours from admittance to treatment in my medium-priority case. I call that pretty good for socialized health care.

(Three months later, after several later episodes, I finally got over myself and went to see my private-practice GP paid for by my employer. The condition is in control.)

[(Anonymous)]

I'm in Australia and I second what the other have said. Emergency, life threatening stuff gets treated immediately as do ongoing conditions like diabetes etc. My dad has had various life threatening things over the years and he was always in and being treated practically instantly regardless of his insurance status. And it didn't cost him tens of thousands of dollars when he didn't have insurance. Elective surgery ie you need this done but it's not going to kill you if you wait, has waiting lists for the more common things unless you have private health insurance and can use the private health service.

[saruby.livejournal.com]

As others have said, I suspect this is a question of a hip replacement, not treatment, which is emergent and probably treated as such. Assuming that, I don't think it's a lot different than the U.S. My partner waited approximately 3 months after getting a referral to get an appointment with an ENT surgeon and another 3 months for surgery for a deviated septum which had been there for 20 years and was clearly no emergency. This was with PPO insurance, not HMO or major medical. I broke my wrist and it was set within hours. It turned out later I needed surgery (pins) because the bones weren't knitting properly and I was scheduled for the morning after the determination was made. So, emergency treatment/surgery was quick, but non-emergent was slow. And then there are the numerous cases of faceless people rather than doctors who determine whether or not your recommended treatment is "necessary" or covered by the insurance at all. While I realize this may not be any better in countries with nationalized medicine, it irks me that a person I will never see is making my medical decisions for me. A friend of mine married a German girl and then got a sinus infection a week later, the day before he was due to fly back to the U.S. Even though he'd only been married a week, he was given care as if he had already been enrolled in the socialized medical system, got meds immediately and only had to postpone his flight by one day. All he had to do was show up with his marriage certificate. I can't imagine any U.S. provider covering treatment that quickly after a marriage, if only because you have to go through the tedious process of adding a dependent and paying the premium, which must then be posted to the system by some bored clerk who'd rather be doing something else. I'm covered by my partner's insurance through her employer's civil partner program, but I can't get vision or dental coverage which is automatically offered to straight spouses. So, I've been waiting for 3 years to get new glasses while I've been in school.

[stephanieburgis.livejournal.com]

I'm an American now living in the UK, and I haven't had slower treatment for any major issues here than I did in the US. The only cases where waiting times took a while were for chronic, non-emergency issues, because emergency cases always get access to the facilities first (which makes sense to me, so I don't mind).

Australia national health

[(Anonymous)]

While on vacation in 2006 local tv in Sydney talked about people needing radiation treatment for cancer often end up on the waiting list so long that their staus changes to radiation to control pain in hospice.

Health care in Australia

[pakwa26.livejournal.com]

I tore my Anterior Cruciate Ligament skiing in 1994; we didn't have any private health cover & i waited 2 years for a reconstruction in the public system, because it wasn't life threatening. My F-I-L fell over & broke his hip & was operated on the next day. He had private health cover but all emergency cases are treated immediately.