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This is with reference to the article titled “For Whom Do We Toil” which appeared in MJAFI 2001; 57: 52-4.
Utilisation of a hospital is studied by a complex of hospital bed and population utilisation indices. Average length of stay alone is an unreliable indicator, as the figure will vary as per the role of the hospital and the type of patients being treated. Moreover, low mortality Figure, as mentioned in the study, simply represents an outcome measure of the hospital. To be meaningful, these data should have been case-mix adjusted. Efficiency in health care is an elusive concept due to intangibility of most of the outcomes of a health care organisation. I think the author meant effectiveness and efficiency, while discussing the delivery profile of the hospital. I wish the author could have carried out a more comprehensive study of the utilisation indices and the outcome profile of the hospital and then benchmark these data with that of similar sized service and civil hospitals, before commenting on the efficiency of patient care being delivered. I congratulate the author for bringing out the tremendous wastage of scarce resources due to admissions for medical board, which needs to be addressed by our service HQ.