How a malpractice insurer grew too big & too fast.
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The existence of cottage hospital beds is historically determined rather than planned, and there is apparently no official ratio for the provision of such beds. A comparative study, in North-east Scotland, of populations with and without access to cottage hospital beds suggests that providing 1.5 beds per 1,000 population is a reasonable basis for future discussion and planning.
In a study in North-east Scotland, nine out of ten patients had a "medical" reason for referral to hospital-in half it was the severity of their illness and in half the need for investigation or special treatment. One out of five patients was in need of intensive nursing care and one out of 20 patients had a social reason for admission to hospital. General practitioners with access to cottage hospital beds would choose to treat over one quarter of their own patients. The choice of hospital was influenced by the doctor's diagnostic certainty.
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