Community care: does it reduce the need for psychiatric beds? A comparison of two different styles of service in three hospitals.

The admission pattern of under-65s during the first seven years of Kidderminster's District General Hospital Psychiatric Department was compared with the last seven years of the mental hospital (Powick Hospital) which it superseded in July 1978, and with its nearest mental hospital (Barnsley Hall Hospital). In Kidderminster the average length of patient's hospital stay was half that at Barnsley Hall. There were more admissions per head of population, more which lasted less than a week, and more patients with over six admissions to Kidderminster than Barnsley Hall. The retrospective comparison with Powick Hospital showed that these differences were not due to the superior community facilities in Kidderminster since there was no real change in hospital bed use with the development of community services; this supports the view that there is a bed-rock of illness which will always need in-patient care however comprehensive the community resources.