Location, location, location! Where to locate ambulatory care facilities? Five different models offer varying advantages and disadvantages.
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Biomedical subjects
Publications and source records attributed to H J Gershon.
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Current and anticipated changes in the mental healthcare delivery system demand a comprehensive facility planning process. As reimbursement for acute care decreases and the influence of managed care increases, most private psychiatric hospitals will need to develop a facility master plan to best use their current buildings and property. The facility master plan will become a road map and provide a logical route for expanding, modifying, and using current hospital assets during the changes imminent in the years ahead.
Whether or not geropsychiatric services are developed by individual hospitals depends on several factors, not the least of which are current geriatric volume, physical capacity, availability of increased staff, psychiatrists' interest, community linkages, and perhaps most important, the facility's ability to modify its operational procedures as required. Geropsychiatry is in its early stage of growth. Southern hospitals that can overcome the operational problems of delivering inpatient care to this population will find themselves developing a market segment that has been overgeneralized, overlooked, and subsequently underserved.
The growth in the number of psychiatric beds has continued unabated since the passage of Medicare and Medicaid, and trends indicate further development will occur. While freestanding facilities have grown in number, a greater degree of growth in beds has occurred in the medical/surgical environment where psychiatric patient units have been developed or have been converted from other purposes. In regulating these different types of psychiatric facilities, most states have adapted regulations from those developed by the Department of Health Education and Welfare (now Health and Human Services) that apply to medical/surgical hospitals. The result is often a situation where important distinctions between patient populations are ignored or patient needs are overlooked. Some more progressive states have developed regulations that are independent of HHS' requirements. The authors have found that even in those states where separate regulations exist, the unique needs of psychiatric patients may not be met.
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