Study highlights difference in outcomes after heart surgery between private payers and NHS

A new study has found that patients who pay 20 percent are less likely to die or develop major complications, such as relapse or stroke, after heart surgery than NHS patients – research states that it cannot be explained by socio-economic factors alone.

The study, led by academics at the University of Bristol, looked at the data of more than 280,000 patients who underwent adult heart surgery over a decade from 2009 to 2018 at 31 NHS heart units in England. Of these, 5,967 were private payers and 274,242 were government funded.

Private payers are treated by the same clinical teams but can ask their surgeon and when they will have surgery. They also have access to ‘Cinderella services’ such as enhanced menus and single rooms.

Umberto Benedetto, Associate Professor of Heart Surgery at Bristol School of Medicine: Translational Health Sciences (THS) from the University of Bristol is an NHS cardiac surgeon and co-lead author of the research, published in Lancet Regional Health Service – Europe. He said the study raised important questions about why there is a big difference in health outcomes between government-funded patients and those accessing NHS healthcare through a private payment scheme, even after consider socio-economic factors.

These are patients who are treated in the same hospitals, with the same clinical teams, but nevertheless we have found significant differences in survival between those who pay. And those that do not.

It is a shame to accept that private payers have this with a richer quality of life and therefore a better quality of life with fewer capabilities. However, after examining the data, we found evidence to support the view that private patients are receiving better care. “

Umberto Benedetto, Associate Professor of Heart Surgery, Bristol School of Medicine

Researchers used data from the National Adult Surgical Research Survey (NACSA). They looked at several outcomes: primary in-hospital mortality, but also postoperative cerebrovascular accident (CVA), renal dialysis, maternal injury infection, and revision.

To rule out socioeconomic status as the sole or main reason for difference in clinical outcomes between private payers and the NHS, the researchers used socioeconomic status information by linking to Iteration of English Deprivation (IoD).

Dr Arnaldo Dimagli, Honorary Research Fellow at the University of Bristol and lead author, said:

“Our findings support the notion that there is a complex interaction between socioeconomic and health system factors for patients undergoing heart surgery. This should encourage further studies to Identify interventions that can address health inequalities, for example, NHS payers may have to wait longer to get their work done This may reduce the risk of having surgery which will affect their results. “


Magazine Reference:

Benedetto, U., et al. (2020) Difference in clinical outcomes after heart surgery between private and public payers (NHS) in England. Lancet Regional Health Service – Europe.