Health Planning in the United States Issues in Guideline Development, Report of a Study (1980) / Chapter Skim
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III. National Health Planning Guidelines; A Discussion
III. National Health Planning Guidelines; A Discussion
Pages 29-40
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From page 29... ...
These were to include health planning goals and standards respecting the supply, distribution, and organization of health resources. In 1977, the Secretary issued the first proposal of standards for nine health services, aimed at controlling costs, reducing hospital capacity, and improving quality of health care.
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From page 30... ...
Local planners testified on behalf of the need for a national health policy because its absence created problems for them (Most, et al, 1976; Committee on Interstate and Foreign Commerce, 1974; Zwick, 1978~. Several observers noted its lack as one of the flaws in previous programs, such as the Regional Medical Program and the Comprehensive Health Planning Program (Hilleboe, et al, 1972; Klarman, 1976b)
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From page 31... ...
The establishment of the guidelines "by regulation", which refers only to the required use of the formal rulemaking process, ensures that the federal government has to develop the guidelines in a prescribed manner, proposing them and allowing time for public reaction, before they become regulations. The Act defines the guidelines as health planning goals and resource standards, an unusual definition specific to this Act.
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From page 32... ...
have substantial health resources and other areas few or none. Guidelines, including normative resource standards, can be used to set targets and to measure progress toward a more equitable, but not necessarily uniform, distribution nationally.
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From page 33... ...
For instance, as part of the local planning process, acute care hospitals should be required to describe their programs and their program's compatibility with other hospitals in their community as part of the plan development or function of the HSAs. This process would bring hospital administrators and trustees face to face with other community interests involved in the planning process, foster the view that individual hospital programs should not be viewed independently of others, and encourage better institutional planning.
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From page 34... ...
of the National Council on Health Planning and Development in an open, participatory process involving business, industry, labor unions, consumer groups, providers, educators, and others who affect or are affected by any significant change in the health system. Although the guidelines would be used principally by health planning agencies, with only HSAs and SHPDAs being required to use them, the committee believes that the guidelines can be usefully incorporated into programs throughout the nation, including other programs inside and outside DREW.
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From page 35... ...
The national priority of service to medically underserved areas, for example, could be approached in a variety of ways, such as physician's placement or employing other professionals linked through technology to physicians and hospitals. Ideas, particularly those proved effective in application, could be shared as part of a "package" of alternative means toward a given end and the related resource standards as "rules of thumb" to help those doing the local planning.
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From page 36... ...
While there may be reasons related to human scale or traditions of design for choosing a particular door width, what is important about this type of standard is that it is an agreed-upon technical convention. (Hospital furniture manufacturers rely on standard door width to accommodate the dimensions of their products.)
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From page 37... ...
The 1979 amendments to the planning Act require automatic approval by the state agency under certificate of need for life, safety, and other important codecompliance capital projects unless the project does not conform to the state plan or is excessive. Standards also are useful to program administrators, especially in large programs, as a source of quick and inexpensive information.
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From page 38... ...
* While the committee did not specifically examine progress made toward regionalized networks of services, which were important goals in the Act, it is noteworthy that a number of the resource standards issued provide concrete guidance aimed at fostering regionalized systems of service that both enhance quality and conserve costs.
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From page 39... ...
The committee believes that, if resource standards are issued, guidelines formulation should begin with related health goals. Health goals provide a direction for planning for health service in an area and may enhance their coherence, increase opportunities for innovation, and, when numerical standards are involved, help avoid misunderstandings about the purposes of the standards.*
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