Wednesday, 5 March 2008

Bad bad science

This 'study' is meant to show how cost effective diabetic nurse specialists are, however even by just glancing at the details of the 'research' one can see several rather gaping holes in the logic used:

"The DSNs managed to identify and review 111 people with diabetes, of which 47 (42%) were discharged within 24 hours.

The average hospital stay for a person with diabetes is normally 11 days, according to the study, which is being presented at the Diabetes UK Annual Professional Conference in Glasgow.

With an average daily bed stay at the trust costing £215 in 2007, 47 fewer admissions equates to a saving of £111,155 for the hospital a year.

Translated across the NHS, this could be up to £100 million a year, researchers said."

How many dubious assumptions do they want to make? They assume that all the discharges were as a direct result of the nurse specialist's input, I wonder if they have any evidence for this assumption at all. They also assume, extremely naively in my opinion, that these patients that were discharged within 24 hours would have stayed another ten to eleven days if it were not for the nurse specialist! The so called research has now fallen apart right in front of our eyes.

At best even if we assume that the diabetic nurse specialists prevent 47 admissions a year in this hospital, and that these patients stay a day less in hospital, then they are only saving the hospital ten grand a year. I bet you the cost of employing a specialist nurse for this amount of time would cost well over ten thousand pounds, plus it's not as if they use no equipment and incur no other extra costs to the hospital. At worst the diabetes nurse specialists prevent no admissions and wast money, one cannot just assume that because 42% were discharged quickly within 24hrs that this would not have happened anyway. This research is a turd burger that relies on stupid assumptions. I am just amazed at how uncritically it is being analysed in the media.


Anonymous said...

I am glad this has been posted and taken apart. it has been spouted to us medical students at our trust as "proof" that the nurses are just as good if not better than us.
I know i am only just about to graduate but i still see and hear things that leads me to believe that we are a long way from replacing doctors with these new HCP's.

Rob Clark said...

This is politics masquerading as medicine.

For a start, I’d love to know where the figures for average admissions come from. When my son was diagnosed with Type I three years ago, he was in for one day; when my daughter was diagnosed two years ago, she was in for around 2 hours. Neither has since had to return to hospital for diabetes-related reasons.

Surely most hospital admissions for diabetics are either for severe hypos (which happens, unfortunately) or, more commonly, because patients haven’t taken responsibility for their condition. The report says: “They actively identified people with diabetes, helped organise their care and encouraged patients to look after themselves”. No shit, sherlock.

Anonymous said...

your first paragraph is reasonable. It is obviously crap research.

your second paragraph is full of even more assumptions than the research. Nice closing line though.

Anonymous said...

You just don't get it do you?

Garth Marenghi said...

don't get what?

if you are going to comment, I have no problem with criticism, I do not have time for silly little comments with no content

Anonymous said...

ooh get you

Garth Marenghi said...

the point is that you probably don't! (get me that is)

try re-reading my piece and then replying with some criticism as you wish, I'm happy to have a good argument!

Managing Diabetes said...

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