Reducing the length of stay in hospital.

Unlike their British counterparts, Soviet health care planners have long adhered to a strategy of adding to the number of hospital beds each year. Consequently, the proportion of the population admitted to hospital has grown steadily; by 1983 this had reached the historically high level of 2477%. Although the extra capacity has been advantageous in several respects, it can scarcely have encouraged rigorous assessment of traditional practices that entail the use of expensive inpatient facilities. Two key series of official statistics for 1974-81 support this contention. The first records that the average duration of stay during this period lengthened from 17 4 to 17 6 days in urban units and from 13 4 to 14 6 days in rural hospitals. The second series shows that only a marginal improvement occurred in the average number of days in a year on which a hospital bed was being used rather than lying empty: the figure rose slightly from 326 to 328 in urban areas and from 311 to 312 in the countryside. These data relate to all the units for which the Union Health Ministry is responsible, and hence to most Soviet hospitals.