Health Planning in the United States Issues in Guideline Development, Report of a Study (1980) / Chapter Skim
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Appendix B: Final Version of National Guidelines for Health Planning
Appendix B: Final Version of National Guidelines for Health Planning
Pages 89-106
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From page 89... ...
~Appendix B Final Version of National Guidelines for Health Planning (March 28, 1978)
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From page 90... ...
Applicability of national guidelines to State health plans. Responsi bi I ity of health systems agencies.
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From page 91... ...
Each State's State health plan developed under Title XV of the Act must be "made up of" the Health Systems Plans of the health systems agencies within the State, revised as found necessary by the Statewide Health Coordinating Council to achieve their appropriate coordination with each other or to deal more effectively with Statewide health needs. (Section 1524(c)
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From page 92... ...
(c) Any proposed adjustment under this section and the analyses supporting it must be reviewed by the State health planning and development agency in its preparation or review of the preliminary State health plan under section 1523(a)
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From page 93... ...
of the Act. On the basis of that review, and consistent with Statewide health needs and the need to coordinate Health Systems Plans as determined by the Statewide Health Coordinating Council, the adjustment may be made part of the State health plan.
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From page 94... ...
Thus, 4.0 beds per 1,000 population is a ceiling, not an ideal situation. HSAs are expected to identify the desirable local ratio, working closely with the State Health Planning and Development Agency and the Statewide Health Coordinating Council.
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From page 95... ...
This concern has not only to do with the cost of maintaining unused hospital bed capacity, but also with the unnecessary and inappropriate uses of hospital beds, especially those in the short-term care category." Occupancy rates currently average about 75% nationwide. Many hospital capacity studies, including those by InterStudy and the Bureau of Hospital Administration of the University of Michigan, indicate that an average hospital occupancy rate exceeding 80% is a reasonable target.
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From page 96... ...
(1 ) Obstetrical services should be planned on a regional basis with linkages among all obstetrical services and with neonatal services.
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From page 97... ...
In determining the 1,500 target, the Department took into consideration these reports as well as the comments received from the public and from members of the expert advisory panel, particularly the criticism that a 2,000 target was too high. The 1,500 level is in line with the policies of many local and State health planning agencies and can help assure more economic use of specialized resources while avoiding inappropriate utilization of such facilities.
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From page 98... ...
Neonatal special care is a highly specialized service required by only a very small percentage of infants. The Department believes that four neonatal special care beds for intensive and intermediate care per 1,000 live births will usually be adequate to meetthe needs, taking into account the incidence of high risk pregnancies, the precentage of live births requiring intensive care, and the average length of stay.
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From page 99... ...
Standard. Pediatric units should maintain average annual occupancy rates related to the number of pediatric beds (exclusive of neonatal special care units)
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Open heart surgery for congenital and acquired heart and coronary artery disease represents a marked advance in patient care. Highly specialized open heart procedures require very costly, highly specialized manpower and facility resources.
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From page 101... ...
Several State health planning agencies, such as New~lersey, suggested a higher minimum level and the Department will be considering whether a higher level should be established in the future. The Department has also determined the existing units should be performing more than 500 cardiac catheterizations or 250 pediatric cardiac catherizations before a new unit is opened.
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From page 102... ...
The established levels are consistent with the recommendations of the Section on Cardiology of the American Academy of Pediatrics and the InterSociety Commission on Heart Disease Resources. The patient studied in the cardiac catheterization unit is frequently recommended for open heart surgery.
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From page 103... ...
In t974, the Department commissioned a study of the use of radiation therapy units. A committee appointed by the American College of Radiology and the American Society of Therapeutic Radiology to review that study suggested that economical operation of radiation units would call for existing units to do 5,000-8,700 treatments per year.
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From page 104... ...
For scanners capable of pertc~rm~ng both head and body scans, it is imperative that they be effectively used in order to spread the high capital expenditures over as much operating time as possible. As the Institute of Medicine report stated, "The high fixed cost of operating a scanner argue for as high a volume of use as the equipment allows without jeopardizing the quality of care." The Department believes that a 50-55 hour operating week is both consistent with the actual operating experience of many hospitals and a reasonable target.
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From page 105... ...
The Health Systems Plans established by HSAs should be consistent with standards and procedures contained in the DHEW regulations governing conditions for coverage of suppliers of end-stage renal disease services, 20 CFR Part 405, Subpart U
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