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enter image description here

I don't think the number is correct.

Jamiec
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Tim Galvin
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    I've edited the question to something that is effectively claim and that we can answer. If you are OK with it I'll reopen, otherwise choose another explicit, specific claim and edit accordingly. – Sklivvz Oct 01 '16 at 08:48
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    Just to make it clear to all readers: the sums quoted are the (estimated) cost to the NHS, not to the patient. All these services are free of charge. – TonyK Oct 01 '16 at 11:54
  • What is the source of this claim - a cropped photo suggests that something important has been cut off – mmmmmm Oct 01 '16 at 12:15
  • But the real question I was getting at is: does a visit to AE for someone with a minor complaint really cost more than the equivalent visit to the GP.. And why? Does the hospital utilise more expensive resources and why – Tim Galvin Oct 04 '16 at 14:05
  • @TimGalvin I don't think that's one we can answer, there is no [notable claim](http://meta.skeptics.stackexchange.com/questions/2506/what-is-a-notable-claim) there. – Jamiec Oct 04 '16 at 14:45
  • @TimGalvin That is a good question: if the A&E were organised to treat minor conditions effectively it would be cheaper. A&Es are paid different rates for different treatments ranging from £56 to about £240. The number quoted on the poster is the average across a typical mix of patients. But costing systems are not very good so the *real* costs may be different. – matt_black Oct 05 '16 at 08:50
  • @TimGalvin And the costing for GP activity is even more fuzzy. We know the total cost of paying GPs but there is no reliable count of how many appointments they have every year and it is unclear whether estimates of cost include the cost of the drugs they dispense (which would double the cost of GP services if we included it). – matt_black Oct 05 '16 at 08:54
  • @matt_black so really it is just poor accounting. I'd say that if AE receives funding on such a poorly constructed basis, they probably make a profit on the "time waisters" which they use to subsidise more costly and serious cases. No one has said anything that makes me think the poster isn't nonsense... – Tim Galvin Oct 09 '16 at 15:09
  • @TimGalvin Actual payments to A&E departments are based on hospital estimates of average costs (which might be rubbish). Hospitals also make additional money if they admit the patient. More importantly, the cost is an *average* not the extra *marginal* cost of treating an additional patient, which is what really matters if patient behaviour changes. Sine most costs are fixed, the marginal cost is likely much lower. – matt_black Oct 09 '16 at 15:17
  • @TimGalvin None of that means the numbers quoted are completely rubbish and the basis of calculation is fairly clear in the NHS. – matt_black Oct 09 '16 at 15:18
  • @matt_black yes not rubbish.. They just don't lead to the conclusion the poster is arguing for. So it's basically a lie. The "stepping into" phrasing I read as "marginal cost". – Tim Galvin Oct 09 '16 at 15:24
  • Given hospitals at 24 hours they are likely to be much more efficient in their use of capital. I just don't buy it at all. – Tim Galvin Oct 09 '16 at 15:25

1 Answers1

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Just to start of with some clarity, the cost to the patient of all of these services is nil. This poster is advertising the cost to the National Health Service of various forms of treatment. Presumably, the intent is to make users of these services aware of how much they are costing the health service.

Most of these figures appear to be taken from studies performed periodically on the usage of NHS services. One is easy to find online - Reference Costs 2012 - 2013 - gov.uk

That report contains a summary, which has similar figures to the image in this question (possibly adjusted for local variation, or possibly average over the report year and previous year).

Some headline statistics from the 2012-13 data12 (with comparisons against 2011- 12) are as follows:
• 2012-13 reference costs cover £55.2 billion of NHS expenditure, an increase of £1.7 billion (3.2%) over £53.4 billion in 2011-12
• This represents 54% of £102.6 billion13 NHS revenue expenditure in 2012-13
• 5.6 million data items were submitted by 244 NHS trusts and NHS foundation trusts
• Detailed costs were provided for 2,100 treatments or procedures covering over 15 million FCEs within admitted patient care alone
• The average cost of a day case is £693 (£682)
• The average cost of an elective inpatient stay excluding excess bed days is £3,366 (£3,215)
• The average cost of a non-elective inpatient short and long stay combined excluding excess bed days is £1,489 (£1,436)
• The average cost of an excess bed day is £273 (£264)
• The average cost of an outpatient attendance is £108 (£106)
• The average cost of an A&E attendance is £114 (£108).

I have highlighted the specific item in the above summary which seems to answer this question in the affirmative.

Jamiec
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  • Not really, unless the comparison is drawn on a like for lime basis. I.e. Same condition. Do you know if that is the case? – Tim Galvin Oct 05 '16 at 09:02
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    Not really *what*? – Jamiec Oct 05 '16 at 09:03
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    @TimGalvin I still don't follow what your first comment meant. The number is based on the *average* cost of an A&E visit. – Jamiec Oct 05 '16 at 11:01
  • The average reason for going to AE is clearly more expensive than the overage reason for going to a GP. The implication of the poster is that going to AE with a minor condition costs the NHS more than if you were I go to the GP. I see no a priori reason for this. For example, if I turn up to AE it should be cheaper than the GP, as it will be dealt with by a nurse. The alternative explanation is that for the same condition, AE gives better treatment or somehow less efficient.. – Tim Galvin Oct 05 '16 at 11:05
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    Jamiec has already answered the factual side of the question. So I'll answer the followup in the comments - Why? Assuming you spend the same amount of time seeing a doctor and the final treatment is the same why is one three times the price of the other? It's fairly obvious if you consider the overheads for the two. GP - A receptionist and normalish office building. Most medical equipment is low tech and cheap. A&E - A receptionist, multiple nurses per doctor, space in a hospital rather than office building, the same basic equipment plus more advanced medical equipment (some shared with the re – Andrew Oct 05 '16 at 12:11
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    @TimGalvin: The NHS document explains in considerable detail how its numbers are calculated. In particular, there is a note about "adjusting for casemix" which I didn't completely understand, but seems to be in the direction of your question. – Nate Eldredge Oct 05 '16 at 12:36
  • People don't go to the GP with broken limbs and other serious injuries. X-Ray machines and blood transfusions are expensive, as is a fully-staffed emergency ward vs. one doctor in an office. – OrangeDog Oct 05 '16 at 22:11
  • A&E is costing money even when no-one is using it... – Benjol Oct 06 '16 at 11:04