Abstract
Objective:
As pres sure mounts to re duce the number of costly acute care beds, gov ernments and the lit era ture pro pose top- down ra tios. Is this rea son able and fair to the re spon s ible medi cal of fi cers who, as the key care pro vid ers, will need to ad mit pa tients and de velo p dis charge plans in a reduced- beds en vi ron ment?
Method:
Treat ing phy si cians of all acute care in pa tients on a given day
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Results:
On a given day, only 62 of 212 in pa tients were un suited for any al ter na tive to acute care hos pi tali za tion. A floor ra tio of 18 acute care beds per 100 000 in habi tants seems ade quate for the catch ment area in ques tion, pro vided that al ter na tives to hos pi tali z ation are fully and ef fi ciently avail able. Al ter na tives es sen tially in volve an ar ray of the follow ing: su per vised resi den tial set tings, day hos pi tals, and in ten sive home care (2 to 6 hours weekly). The ra tio of in ten sive home care work ers re quired would be 25 per 100 000 in habi tants.