Biomedical subjects
Publications and source records attributed to R E MacStravic.
Marketplace competition to rationalize health care delivery costs has been a topic of much discussion recently. Several new plans have been suggested, including the individual risk, provider-as-purchaser plan described here. The plan puts physicians in control.
Although legal and practical barriers still remain before vertical integration of health care facilities can reach full potential, this kind of multi-institutional arrangement deserves greater attention.
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The importance of variations in hospital census for planning bed requirements has long been recognized. Traditional models assume Poisson or normal distribution patterns accurately describe such variations in specific hospital units, entire facilities, and groups of hospitals serving the same area. A study of 20 groups of hospitals in five states indicates that these traditional statistical distributions are only occasionally accurate. Different services display different census variation patterns. The standard deviation of the daily census distribution becomes increasingly higher than the square root of the mean estimate as the size of the mean increases. Implications of this finding for regional planning and coordination of hospitals are discussed.
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Decisions regarding resource requirements are often based on single-factor decision rules. Although the use of such rules will simplify the decision process, these rules ignore the multiple consequences of each decision. Instead the health care administrator should base a decision on the mix of performance promised by a given resource decision.
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Do we really want to limit hospital beds to 4.0 per thousand in every health service area? Are 80 percent occupancy and 1,000 patient days per thousand really what we want? The author suggests the goals are contradictory, and poses an alternative--variable occupancy standards.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
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A preliminary analysis of the 1973-74 national assessment of comprehensive health planning [P.L. 89-749, sections 314 (a) and (b)] agencies is reported. The analysis suggests that agency staff size and budget are more strongly related to high performance scores than is size of population served. Complete analysis of the 1973-74 assessment data was not possible because of time constraints; it is argued that plans should be made for detailed analysis of data from future assessments of planning agencies under P.L. 93-641 so that factors relevant to performance may be identified more precisely and incorporated into agency structure.
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