Clinical Medicine or Community Health Care.

Abstract

"There is much evidence that expenditure would have been better directed towards more public health services designed to prevent rather than to cure disease. Regarding the provision of personal services it seems that these would be more efficiently provided by more diffuse community services than by hospitals. For example, the capital costs of a single teaching hospital in Africa may exceed the entire annual recurrent health budget of the country in which it is situated. In principle such hospitals should function not only as a teaching base but as the peak of a medical care referral system. They do not do so in many parts of Africa."