8. The formula is:
Hospital bed require- ments for each medical-- type
Discharge Population Percentage Length of
rate per x in X distribu- X
stay (days)
thousand thousands
tion
365 x Percentage occupancy
In using this formula for the present report the population figures are those forecast by the Census and Statistics Department in the Census Circular 6/72 on the basis of the 1971 Census. The waiting list figures (f) are generally low at present and have been assumed to remain con- stant. The other data are the best currently available but it is clear that the statistics available are inadequate in certain respects and will require further refinement by the Statistical Unit of the Medical and Health Department. For instance, a more accurate assessment of the appropriate proportion of acute to non-acute beds at present and in future has to be made. When such further data are available it is hoped that the hospital-bed requirement will be recalculated in the first annual review of the plan for 1973-82 to be carried out in early 1974 by the Committee. This is of importance because without such data the pro- portion of beds which should be in regional or in district hospitals (the costs of which differ considerably) is difficult to calculate. The Com- mittee recommends that additional staff be made available to augment the Statistical Unit of the Medical and Health Department as soon as possible.
9. The formula yields the following information on hospital bed requirements:
Year
Medical Surgical and and Paed. Gyn.
Mater- nity
Chest Infec-
and tious Leprosy Thoracic Diseases
Psychi- atric
Geriatric Total
1972
5,684 4,816 1,978
1,612
128
100 4,937
0
1973
5,968 5,058 2,096
1,632
128
100
5,022
34
19,255 20,038
1974
6,235 5,267 2,229 1,612
128
98
5,122
71
20,762
1975
6,443 5,481
2,338 1,612
122
96
5,205
110
21,407
1976
6,650 5,706
2,446
1,612
122
94
5,301
150
22,081
1977
6,849 5,936 2,555 1,612
117
92
5,401
190
22,752
1978
7,240 6,177 2,664 1,597
117
89
5,506
229
23,619
1979
7,655 6,426 2,771
1,597
112
87
5,613
269
24,530
1980
8,094 6,680 2,876 1,597
112
85
5,724
309
25,477
1981
8,519 6,944 2,980
1,597
108
83
5,839
351
26,421
1982
8,965 7,308 3,085 1,597
108
80. 5,957
395
27,495
4
These are the total requirements in the Government, Government- assisted, and private sectors. The overriding factor causing the rising demand is, of course, the growth of the population. If one takes the population estimate for 1982, i.e. 5 million, reduces the figure into units of a thousand, i.e. 5,000, and divides that number into the total bed number of 27,495, it emerges that the formula sets a desirable overall ratio of provision of hospital beds per 1,000 population of 5.5 per thousand by 1982.
10. This is to be regarded as the general Colony-wide standard to be set for the end of 1982. Whether it can be achieved is a different matter. Samples of bed provision in other countries are given at Appendix 1 for the purpose of comparison. How the table above breaks down into Government, Government-assisted, and private beds is shown in Appendix 2.
11. The demand for clinic services can be expressed in terms of doctor-sessions. In the case of general out-patients clinics demand depends on four factors:
(a) Size of population or, for some specialities such as maternity,
size of a sector of the population.
(b) Attendance rate per thousand population.
(c) Percentage of attendances seen by a doctor.
(d) Attendances per session.
In the case of special clinics (c) is generally less relevant because most patients are seen by the doctor.
12. Data available on (b), (c) and (d) in respect of Government clinics have been used to calculate the demand for clinic services provided by Government. Likely increases in the attendance rate per 1,000 population, changes in the percentage of attendances seen by a doctor as opposed to a nurse, changes in the length of time of a con- sultation (affecting the number of attendances possible per session) have been studied, and on the basis of forecast changes in these factors accepted by the Committee the total demand for doctor-sessions at Government clinics can be summarized as follows:
5
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