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Feature Data Briefing

Hospitals: what do they do and how much does it cost?

BMJ 2012; 344 doi: (Published 14 March 2012) Cite this as: BMJ 2012;344:e1759
  1. John Appleby, chief economist
  1. 1King’s Fund, London W1G 0AN, UK
  1. j.appleby{at}

John Appleby takes a look at where the NHS budget goes

The death of the hospital has been widely predicted—indeed advocated—since (probably) moments after Rahere (courtier, jester, and clergyman) flung open the doors of St Bartholomew’s in 1123. But hospitals are survivors: in Barts’ case, of the Great Fire of London and the dissolution of the monasteries.1 And there are good practical reasons for concentrating some types of healthcare service in one place: it’s generally a more efficient use of expensive resources, produces better health outcomes, and acts as a physical focus for research.

To survive, hospitals have also had to change. Advances in clinical techniques and better community and home care have led to shorter hospital stays and consequently …

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