An assessment of the comparative advantages of paediatric activities using routine hospital records

Abstract Comparison is made of the advantages, in terms of benefit to patients and salary costs, of employing a consultant paediatrician and non-specialist physicians in clinical work, management activities, research, and education. Comparisons are based on data derived by a simple method from inpatient records of 10 125 children aged 0-5 years admitted over a 23-month period to Mbale Hospital, Uganda. Benefits to inpatients were assessed from the quarterly death and failure rates and the proportion of failures occurring within 24 h of admission to hospital. The relative costs of the various items of medical work were based on the salary costs that they incurred. The advantages of one activity compared with another are demonstrated, and the results clearly indicate that greater benefit at lower cost was obtained by the use of physicians in management and supervisory work than by employing them in the routine care of inpatients.