EXCESS CAPACITY AND OVERUTILIZATION OF SHORT TERM HOSPITALS IN THE UNITED STATES (FROM SECRETARY'S NATIONAL CONFERENCE ON FRAUD, ABUSE, AND ERROR - PROTECTING THE TAXPAYER'S DOLLAR, P 37-40, 1978 - SEE NCJ-68143)

• NCJ Number: 68149
• Author(s): W H STEWART
• Date Published: 1979
• Length: 4 pages
• Sale Source: Superintendent of Documents, GPO
• Language: English
• Country: United States of America
• Note: NCJ-68149 AVAILABLE ON MICROFICHE FROM NCJRS UNDER NCJ68143.

Annotation

PUBLIC LAW 93-641 MANDATING 4 ACUTE-CARE HOSPITAL BEDS PER 1,000 PERSONS AT A LEVEL OF 80 PERCENT OCCUPANCY AS WELL AS STANDARDS FOR HOSPITAL BEDS CANNOT BE EASILY ENFORCED BECAUSE OF PROBLEMS IN HEALTH CARE SYSTEMS.

Abstract

THE ASSUMPTION THAT EXCESS CAPACITY EXISTS IN THE ACUTE GENERAL HOSPITALS AND THAT PROPER AND MORE RATIONAL UTILIZATION OF LESS BEDS COULD SAVE MONEY IS BASED ON INTERPRETATIONS OF NATIONAL HOSPITAL DATA TEMPERED BY SPECIFIC STUDIES OF HOSPITAL UTILIZATION. THE STUDIES CONCERN VARYING POPULATIONS IN MORE DELIMITED GEOGRAPHIC SETTINGS. THE IDENTIFICATION OF EXCESS BEDS TO BE ELIMINATED, HOSPITAL BY HOSPITAL, IN A COMMUNITY WITHOUT REGARD TO VARIATIONS IN PURCHASING POWER IS AN UNREALISTIC METHOD OF RATIONING RESOURCES. THERE IS LITTLE COMMUNITY EXPERIENCE TO SUPPORT SUCH A MOVE AND A LACK OF ANY SEMBLANCE OF A SOCIAL STRUCTURE THAT CLEARLY CAN BE ASSIGNED THE RESPONSIBILITY AND AUTHORITY TO CARRY OUT THE CONTROL MEASURES. OFTEN HOSPITALS ARE IDENTIFIED WITH A SUBCOMMUNITY WITHIN A LARGER COMMUNITY. AT THE MOMENT IT APPEARS THAT THE PRINCIPAL RESPONSIBILITY TO CARRY OUT THE NATIONAL POLICY IS LEFT TO EACH OF THE 7,000 HOSPITALS--AN IMPOSSIBLE TASK. THE INSTITUTE OF MEDICINE HAS POINTED OUT THAT THE DECISIONMAKING PROCESSES IN THE HEALTH CARE INDUSTRY VIRTUALLY GUARANTEE THE WIDESPREAD DEVELOPMENT OF EXCESS HOSPITAL BED CAPACITY FOR SHORT-TERM GENERAL CARE. MOREOVER, MOST HOSPITAL USE DATA FOR INDIVIDUAL HOSPITALS IN A SERVICE AREA ARE NOT POPULATION BASED SINCE HOSPITALS DO NOT HAVE A DEFINABLE POPULATION THEY SERVE. IF THE NATIONAL POLICY MANDATES THAT HEALTH RESOURCES, SERVICES, AND RELATED SOCIAL SERVICES ARE TO BE DISTRIBUTED AND RATIONED ON SOME BASIS OTHER THAN PURCHASING POWER, THEN AN ORGANIZATION WILL HAVE TO BE DEVELOPED FOR THE DELIVERY OF HEALTH SERVICES AT THE LOCAL LEVEL. THIS ORGANIZATION MUST RECOGNIZE THE CHANGING CHARACTER OF THE HEALTH PROBLEMS OF THE PEOPLE, THE NEED FOR ORGANIZATIONAL CHANGE IN THE DELIVERY OF HEALTH SERVICES, AND THE GROWING LIMITATION OF AVAILABLE FINANCIAL RESOURCES. (MHP)