Smith J W, O'Donovan J B, Hoyle G, Clegg D F, Khalid T
Br Med J. 1973 May 26;2(5864):471-4. doi: 10.1136/bmj.2.5864.471.
Opinions conflict on whether there is a place in the Health Service for general practitioner (community) hospitals in which the patients' treatment is mainly the responsibility of their family doctors. The authors therefore analysed a sample of the patients admitted in the course of a year to a group of two general district hospitals with a comparable sample of the patients admitted to a general practitioner hospital. The aim was to analyse the type of care provided in the general practitioner hospital, to assess whether it was appropriate for the type of cases treated, and to decide whether the patients would have been better off in the district general hospital (and vice versa). The main conclusions are that a district hospital is best for serious illnesses needing skilled decisions and assessments but that most of the work of these hospitals is not of this kind and a community hospital staffed by general practitioners offers many advantages to patients-provided the work being done is constantly under critical assessment. The authors plead for special refresher courses under the N.H.S. for general practitioners working in community hospitals.
对于国民医疗服务体系中是否应存在由家庭医生主要负责患者治疗的全科医生（社区）医院，各方观点不一。因此，作者对一组两家普通地区医院在一年中收治的患者样本进行了分析，并与一家全科医生医院收治的患者样本进行了对比。目的是分析全科医生医院提供的护理类型，评估其是否适合所治疗的病例类型，并确定患者在地区综合医院是否会得到更好的治疗（反之亦然）。主要结论是，地区医院最适合治疗需要专业决策和评估的严重疾病，但这些医院的大部分工作并非此类，由全科医生配备人员的社区医院为患者提供了许多优势——前提是所开展的工作要不断接受严格评估。作者呼吁在国民医疗服务体系下为在社区医院工作的全科医生开设专门的进修课程。
