TY - JOUR T1 - Learning from abroad or policy tourism? JF - British Journal of General Practice JO - Br J Gen Pract SP - 410 LP - 411 VL - 54 IS - 503 AU - Trevor Sheldon Y1 - 2004/06/01 UR - http://bjgp.org/content/54/503/410.abstract N2 - INCREASINGLY, as we become more aware of what is going on in other countries, we realise that healthcare systems, although different, are subject to similar forces. The key issues we face are common: how to contain rising costs, improve quality and efficiency, and, in some countries, promote equity. It is natural, therefore, that we should take an interest in how other healthcare systems finance, organise and deliver health care and the relationship this might have with health outcomes and costs.Major exercises for comparing the performance of healthcare systems have been undertaken. For example, the 2000 World health report compared the performance of 191 health systems.1 This exercise was heavily criticised for the quality of its methodology and its conclusions.2 While international comparisons can be useful and prompt critical discussion about health policy, often they are not sufficiently robust to support the flimsy inferences based on them.2Another exercise that hit the headlines was a comparison between the NHS and Kaiser Permanante, one of the United States’ (US') largest non-profit healthcare organisations.3 This paper, which used detailed statistical analysis to claim that the Kaiser system was more efficient than the NHS, prompted a growing love affair by the Department of Health, which sent teams out to study the Kaiser system and has encouraged Kaiser to operate in the United Kingdom (UK). In this issue of the BJGP Talbot-Smith … ER -