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To the Editor.—
The article "Health Services in the Netherlands" (239: 1558, 1978) quotes hospital usage figures of 1.688 inpatient days per 1,000 population and an average length of stay of 16.6 days.Calculation, using an average occupancy of 90%, results in a bed-population ratio of 5.14 beds per 1,000. (At 85%, a figure often quoted by health care planners as desirable, the figure is 5.44.)Since this is the requirement for a modern, industrialized, progressive, fairly homogenous population, determined by experience and where a well-established system of government monitoring "directs its attention particularly toward quality of services, sufficient and efficient facilities, and use of these facilities for both inpatient and outpatient services" (much as our developing Professional Standards Review Organizations and Health Systems Agencies are attempting to do), why, then, are the bed-population guidelines issued by the Department of Health, Education, and Welfare (DHEW) more than 20% lower? It
Hammel DA. Bed-Population Ratios. JAMA. 1978;240(13):1340. doi:10.1001/jama.1978.03290130034012
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