BMJ Open: Effects of health and social care spending constraints on mortality in England: a time trend analysis

Andy · Nov 17, 2017

Abstract
Objective Since 2010, England has experienced relative constraints in public expenditure on healthcare (PEH) and social care (PES). We sought to determine whether these constraints have affected mortality rates.

Methods We collected data on health and social care resources and finances for England from 2001 to 2014. Time trend analyses were conducted to compare the actual mortality rates in 2011–2014 with the counterfactual rates expected based on trends before spending constraints. Fixed-effects regression analyses were conducted using annual data on PES and PEH with mortality as the outcome, with further adjustments for macroeconomic factors and resources. Analyses were stratified by age group, place of death and lower-tier local authority (n=325). Mortality rates to 2020 were projected based on recent trends.

Results Spending constraints between 2010 and 2014 were associated with an estimated 45 368 (95% CI 34 530 to 56 206) higher than expected number of deaths compared with pre-2010 trends. Deaths in those aged ≥60 and in care homes accounted for the majority. PES was more strongly linked with care home and home mortality than PEH, with each £10 per capita decline in real PES associated with an increase of 5.10 (3.65–6.54) (p<0.001) care home deaths per 100 000. These associations persisted in lag analyses and after adjustment for macroeconomic factors. Furthermore, we found that changes in real PES per capita may be linked to mortality mostly via changes in nurse numbers. Projections to 2020 based on 2009-2014 trend was cumulatively linked to an estimated 152 141 (95% CI 134 597 and 169 685) additional deaths.

Conclusions Spending constraints, especially PES, are associated with a substantial mortality gap. We suggest that spending should be targeted on improving care delivered in care homes and at home; and maintaining or increasing nurse numbers.
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Open access at http://bmjopen.bmj.com/content/7/11/e017722

Article based on this study at http://www.centreforwelfarereform.org/news/government-plling-people/00348.html

Hoopoe · Nov 17, 2017

Isn't disabled or sick people dying an acceptable side effect to the politicians that made these policies?

Andy · Nov 19, 2017

Code:
https://twitter.com/Trickyjabs/status/931947021707153408
https://twitter.com/user/status/931947021707153408

NelliePledge · Nov 19, 2017

Wow I didn't realise SMC were anti poor and disabled people generally I thought it was just people with ME they were against.

MEMarge · Nov 19, 2017

I was horrified about all this SMC stuff when I started looking into it a couple of years ago

Valentijn · Nov 19, 2017

NelliePledge said: ↑

Wow I didn't realise SMC were anti poor and disabled people generally I thought it was just people with ME they were against.
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They're pro-corporation and pro-government, since that's where they get their money from. More specifically, they promote whichever institutions have "donated" money to them.

NelliePledge · Nov 19, 2017

Valentijn said: ↑

They're pro-corporation and pro-government, since that's where they get their money from. More specifically, they promote whichever institutions have "donated" money to them.
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so as they would have said in their revolutionary communist days they are out and out lackeys of the capitalists

Valentijn · Nov 19, 2017

NelliePledge said: ↑

so as they would have said in their revolutionary communist days they are out and out lackeys of the capitalists
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I doubt they've changed much since then. Likely they found that there was a profit to be had from being a revolutionary communist back in the day I suppose there was a similar perception that you could trust communists not to be pro-corporate interest, just like you can trust a "science" center not to be bought by private interests.

Esther12 · Nov 19, 2017

Here's the SMC page on the paper, in case of interest: http://www.sciencemediacentre.org/e...l-care-spending-and-excess-deaths-in-england/

I've not looked at the paper itself, so can't really judge the comments.

Estherbot · Nov 20, 2017

Andy said: ↑

https://twitter.com/user/status/931947021707153408

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There is a blog written by Tom Pride on the SMC's inlfuence on the BBC and its decision not to feature the BMJ piece.

https://tompride.wordpress.com/2017...-mail-and-uk-government-as-fact-checkers/amp/

Unlike other media outlets, the BBC refused to report the story, claiming its ‘independent’ scientific advisers had recommended they ignore the figures, because they were “highly speculative” and should be treated with “caution”:

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So who is this mysterious ‘Science Media Centre‘, which is so influential on the BBC that when it comes to science, its opinion trumps the British Medical Journal and both Oxford and Cambridge Universities?

Shockingly, it turns out the SMC is not independent at all. It is an organisation with a history of pushing corporate interests as well as anti-environmentalism, funded by industry and headed by a controversial genocide-denying journalist with no background in science who was awarded an OBE by the Tories in 2013.
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Estherbot · Nov 20, 2017

Environmentalist George Monbiot who has wriiten about Fiona Fox & the SMC (ironically) in the Guardian has been tweeting...

The links to his website are for his Guardian stories on Fiona Fox & the SMC.

https://twitter.com/user/status/932533618127360000

https://twitter.com/user/status/932533795739365376

https://twitter.com/user/status/932534598432645121

Estherbot · Nov 20, 2017

I have written to George Monbiot via his website about SMC bias via his website. Sprcifically including articles from David Tuller & James Coyne.

David Tuller

http://www.virology.ws/2017/08/02/t...dia-centres-desperate-efforts-to-defend-pace/

James Coyne

https://mindthebrain.blog/2017/09/1...-of-quack-chronic-fatigue-syndrome-treatment/

Esther12 · Nov 20, 2017

I see some people raising CFS/PACE concerns in the replies on twitter. Always good to get more critical attention on the SMC and Fiona Fox.

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BMJ Open: Effects of health and social care spending constraints on mortality in England: a time trend analysis

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BMJ Open: Effects of health and social care spending constraints on mortality in England: a time trend analysis

Andy Committee Member

Hoopoe Senior Member (Voting Rights)

Andy Committee Member

NelliePledge Moderator Staff Member

MEMarge Senior Member (Voting Rights)

Valentijn Guest

NelliePledge Moderator Staff Member

Valentijn Guest

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