Wheeler M
Br Med J. 1972 Oct 28;4(5834):220-3. doi: 10.1136/bmj.4.5834.220.
At the end of 1972 two new "best-buy" district general hospitals should open at Bury St. Edmunds and Frimley, eventually serving their catchment areas at a ratio of two acute beds per 1,000 population. This study shows that one of these areas is already operating below this projected target as a result of a considerable decline in the bed ratio over the past decade. Drastic shortening of the average length of stay has permitted an increase in admission rates from 60 to 79 per 1,000 population over the decade, while costs per case measured at constant prices have fallen. These changes have taken place more rapidly than in the U.K. generally. The evidence points to the pattern of clinical management as the main reason for this and suggests that similar gains could be achieved on a national scale, even without waiting for new buildings and expanded community services.
1972年底,两家新的“性价比高”的地区综合医院将在伯里圣埃德蒙兹和弗里姆利开业,最终以每千人口两张急症床位的比例为其服务区域提供服务。这项研究表明,由于过去十年床位比例大幅下降,其中一个地区目前的运营水平已低于该预计目标。平均住院时间的大幅缩短使得该地区每千人口的住院率在过去十年间从60例增至79例,而按不变价格计算的每例病例成本则有所下降。这些变化比英国总体情况发生得更快。证据表明,临床管理模式是造成这种情况的主要原因,并表明即使不等待新建筑和社区服务的扩展,在全国范围内也能取得类似的成效。