[Trends in tuberculosis hospital and sanatorium beds throughout the world (1960-1975)]

The most important problem facing phthisiologists in the past was how to ensure a sufficient number of sanatorium beds for the management of tuberculosis patients, their rehabilitation and the prevention of transmission of infection by isolating them. There is considerable evidence today, however, that the results obtained with ambulatory treatment are as good as those following in-patient treatment. The latter is now considered unnecessary as it serves merely to prolong duration of the patient's incapacity and to increase the cost of treatment. The presentation of the available information on the trend of beds designated for tuberculosis aims at stimulating the new approach to efficient control of the disease so as to prevent the misuse of available resources. During the period 1960-1965 there were more than 870000 tuberculosis beds reported in the world. Between 1970 and 1975, the number of tuberculosis beds was reduced to 609000. The average percentage of tuberculosis beds to the existing total bed complement was 8.4 in 1960-1uberculosis bed density"--was 3.9 and 3.1 respectively, for the two periods. Owing to the very large variety of reporting systems and sometimes to their defective patterns, international comparisons are hazardous. In general, there is a considerable declining trend in the tuberculosis bed density, in countries with a high initial level, whereas in other countries an upwards trend is sometimes to be found. The analysis of the particular patterns of tuberculosis bed density is difficult, as in many countries the still existing high bed density is actually a combined tuberculosis and respiratory diseases bed density. In countries with a well developed network of institutional units, treatment costs account for approximately half the total cost of the tuberculosis control programme. In a broad public health sense bed strategy is becoming increasingly important since apart from the substantial capital cost of institutional facilities, it also influences both the pattern of service rendered and the use of resources available.