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HEALTH PLANNING IN THE UNITED STATES: ISSUES IN GUIDELINE DEVELOPMENT Report of a study by a committee of the INSTITUTE OF MEDICINE March 1980 Supported by the Health Resources Administration Contract No. 282-78-0163-EJM National Academy of Sciences

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NOTICE The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the Councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competencies and with regard for appropriate balance. This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee con- sisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate profes- sions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 Congressional charter responsibility to be an advisor to the Federal Government, and its own initiative in identifying issues of medical care, research, and education. 2101 Constitution Avenue, N.W., Washington, D.C. 20418 Area (202) 389-6178 Publication TOM 80-01 11

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COMMITTEE ON HEALTH PLANNING GOALS AND STANDARDS Rashi Fein, Chairman Harvard Medical School Professor of the Economics of Medicine Robert A. Derzon Senior Scholar in Residence Institute of Medicine Henry A. DiPrete Vice President, Group Operations John Hancock Mutual Life Insurance Company Derek D. Gellman Vice President of Medicine and Education Vancouver General Hospital Jean L. Harris Secretary of Human Resources Commonwealth of Virginia Clark C. Havighurst Duke University School of Law John K. Iglehart Vice President, Kaiser Foundation Health Plan James R. Kimmey Director, Institute for Health Planning Herbert E. Klarman Professor of Economics New York University Ben R. Lawton Director, Marshfield Clinic Roslyn Lindheim Professor of Architecture University of California Walter J. McNerney President, Blue Cross and Blue Shield Association Anthony T. Mott Executive Director Finger Lakes Health Systems Agency Nora Piore Institute for Health Care Studies United Hospital Fund of New York William C. Richardson Professor and Associate Dean University of Washington School of Public Health and Community Medicine Liaison Members from the National Council on Health Planning and Development S. Philip Caper Vice Chancellor for Health Affairs and Professor of Medicine University of Massachusetts Medical Center _ 111 _ a. Emmerson Ward Professor of Medicine Mayo Medical School

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STAFF Helen Darling, Study Director Mary Anne Cunningham, Secretary CONTRIBUTORS: BACKGROUND PAPERS Bradford Gray (Proce for Development) Jeanne Holzgrefe (Long-Term Care for the Elderly) Carolyn Kohn (Access to Health Care) Jana Surdi (International Study and Selected Activities of Planning Agencies) Sunny Yoder (Configuration of Hospital Services) TV - . .