What could the G.P. treat at home--with proper support?

Best Buy Hospital These considerations underlay the Best Buy Hospital, which was introduced on the basis of an acute inpatient provision of two beds per 1,000. It was assumed that patients would stay a minimum of time necessary in hospital and that there would be full supporting services in the community. Almost independent of the community services, the South East Thames Regional Health Authority has introduced an acute bed norm based on 2 4 beds per 1,000 population for the region as a whole. Within this breakdown, however, an age specific norm had been calculated for each specialty which takes into account the national discharge rate for each age group and also their mean duration of stay. It was also assumed that there would be a mean turnover interval of 2-2 days apart from those specialties in which the national turnover interval is already less than that-that is, gynaecology and dentistry, where the figure of 18 was used. For mental handicap the Cmnd. paper6 recommended specific provision for both hospital inpatients and local authority places. The South East Thames Region7 has proposed that the run down in the hospital inpatient provision from 15 3 beds for children and 93 7 beds for adults per 100,000 population to 13 and 55 places, respectively, will coincide with the proposed-build-up of the local authority services-from 5 6 places for children and 14-5 places for adults to 12 and 75 places respectively in the community per 100,000 population. One could also argue that in the geriatric service and the services for the mentally ill and psychogeriatric cases, similar account should be taken of the community day and residential service in calculating the number of inpatient beds required. Unlike the position with acute beds there has been very little change in the last few years in the discharge rate and duration of stay in geriatric accommodation. Only a very small proportion of the elderly population are in inpatient accommodation at any one time, and perhaps resources would be better used not to increase the inpatient provision but rather the day patient and community services. In providing maternity beds there are even greater difficulties. Ideally these should be based on the fertility rate (the number of births per 1,000 women between the ages of 15 and 44). Nevertheless, like the crude birth rate, even this is changing dramatically, while there have been considerable changes in the …