Cardiac surgery survival inequalities between private and NHS patients

Cardiac surgery survival inequalities between private and NHS patients
© iStock/sefa ozel

A new study has revealed that private medical patients are 20% less likely to die or develop complications following surgery than NHS patients.

The study, led by University of Bristol researchers, showed that NHS cardiac patients are more likely to die early and suffer complications such as stroke or reintervention following surgery, and that the findings cannot be explained by socioeconomic reasons alone.

The study highlighted that private patients are treated by the same clinical teams as NHS patients, but that they can request which surgeon carries out the procedure and when the surgery takes place.

The study has been published in The Lancet Regional Health – Europe.

Inequalities in healthcare

For the study, the researchers looked at the data of over 280,000 patients who underwent adult cardiac surgery over a period of 10 years from 2009 to 2018 at 31 NHS cardiac units in England. 5,967of these were private payers and 274,242 were government funded.

Umberto Benedetto, Associate Professor in Cardiac Surgery in Bristol Medical School: Translational Health Sciences (THS) from the University of Bristol is an NHS cardiac surgeon and joint lead author of the research, said that the study poses important questions about why there is a significant disparity in health outcomes between government funded patients and those accessing NHS healthcare through a private payer-scheme, even after socioeconomic factors had been considered.

“These are patients who are treated in the same hospitals, by the same clinical teams, and yet we have found stark differences in survival between those who pay and those who don’t. It’s tempting to assume this is due to private payers having a more affluent and therefore better quality of life with fewer comorbidities. However, after analysing the data, we found evidence supporting the hypothesis that private patients receive better care,” he said.

Dr Arnaldo Dimagli, Honorary Research fellow at the University of Bristol and joint lead author said: “Our findings support the hypothesis that a complex interaction between socioeconomic and health system-related factors exists for patients undergoing cardiac surgery. This should stimulate further investigations in order to identify interventions which can tackle health inequalities. For example, it is possible that NHS payers have to wait longer to get their operation. This can expose them to the risk of deterioration before surgery which can affect their outcomes.”

The study was supported by NIHR Bristol Biomedical Research Centre (NIHR Bristol BRC).

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