DISCUSSION

Abstract

Dr. Borges: What are the comparative costs of just technical determinations, blood counts, various types of tests, x-rays, technician's time, etc., when you have a comparable number of patients in the hospital and readily available compared to the same number of patients who come in at various times on an ambulatory basis? I think there may be increased cost in ambulatory care, but I have no idea of the magnitude. When the x-ray department can call for the patient at any time that day compared with the one that shows up at 10:15 and then, to extend that example to the availability of all the medical forces at one predictable time when the patient is there for only a finite period of time, I wonder whether there is any data that would allow us to compare the costs on those two bases? Dr. Hartmann: I believe Dr. Hammond has such information. Dr. Denman Hammond: We have some data on inpatient care but insufficient figures relative to ambulatory services. I am trying to recall some of the data we have analyzed over a long period of years from the Children's Hospital of Los Angeles having to do with the proportion of the course of leukemia a child spent in the hospital. Prior to 1953 when we had no cooperative programs nor much in the way of chemotherapy, the course of leukemia in children was rather short. The records up to 1953 indicate that about 30% of the course, from diagnosis to death, was spent as an inpatient in a hospital.