The phenomenon of the corridor patient.

By international standards, the Soviet Union today has an undoubtedly generous ratio of hospital beds to population. Over the years 1950-78, thanks to massive annual increases, the supply rose from 55 7 to 122-0 beds per 10 000 people. These figures for the whole Union conceal substantial spatial variations-as is true for many health care indicators-and the larger centres of population tend to have higher ratios. At the end of 1978 the city of Moscow had 137 7 beds for every 10 000 inhabitants. Even in the capital, however, a shortage of vacant beds in the wards of many hospitals necessitates large-scale reliance on makeshift arrangements in corridors. Although this organisational problem cannot be measured from published data, its existence has been acknowledged recently not in oblique or coded references but in two undeniably frank articles published by Literaturnaya Gazeta.1 2 The first article contains the text of an interview with a head doctor, who among other achievements has managed to return the corridors to their proper use. At this juncture, incidentally, it should be explained that the unit in question is a well-known centre of excellence bearing the title: Order of Lenin teaching hospital named after S P Botkin. In the opinion of its head doctor the problem represented by "corridor patients" was endogenous; he considered that it arose from organisational failures "as a result of which a patient remains too long under hospital care and at the same time does not receive what is essential." The absence of patients in his corridors was closely linked to striking improvements in two standard indices of efficiency-average duration of stay and bed turnover. (The latter represents the average number of patients treated per bed during one year, and in the Botkin hospital this index had risen from 14 5 to 16-4 over the five years 1975-9.)