Community hospitals

BMJ 1994;308:857 (26 March)

Letters

Community hospitals

Community hospitals not available to everyone

Editor,--Small hospitals come into and go out of fashion, asSam Ramaiah says.¹ They have been described as cottage hospitals,general practitioner hospitals, community hospitals, and communitycare centres. One issue that is often overlooked is the equityof care that they provide. For some services (such as outpatientand casualty services) they may improve equity by bringing servicesto rural areas. But for other services such as general practitionerbeds (particularly in urban community hospitals) inequity willarise if only a proportion of general practitioners have accessto these beds. In practice (and leaving aside the problem thatsome general practitioners may not want to use community hospitalbeds) this seems inevitable since most small community hospitalscan cover the patients of only 15 to 20 general practitioners.²In most districts it is inconceivable that enough communityhospitals could be built to serve . . . [Full text of this article]