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The nature and extent of social worker's involvement in regional health planning agencies was the subject of the nationwide study reproted here. Social work proved to be more heavily represented on the professional staffs of these agencies than any other discipline. This was just one of the findings that can help shape the profession's response to the possibilities this new field represents.
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After summarizing the health situation in Honduras and describing the National Health Plan launched in 1973, the authors explain the changes that have come about in nursing, the difficulties that had to be surmounted to reach a new professional position, and the administrative decisions that had to be taken to devise a health policy. An account is given of the changes made in the training of nursing staff and in the functions that staff must perform in the planning, implementation, and evaluation of the coverage extensive program. The article high-lights the role of the Nursing Division in the Ministry of Public Health and Social Welfare and the levels of coordination established with the other technical divisions and institutions responsible for the health personnel training. In closing, the article points out that the nursing sector represents the keystone of the model for the delivery of services to attain the goal of health for all by the year 2000.
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The Christchurch Health Planning and Research Unit was established in April 1975 to develop an approach to regional health services planning based upon researched community need, making the best use of available resources and involving agencies, health professionals and the community. This paper reports on the background to its establishment, the development of a planning strategy and progress and problems to date, especially in the fields of geriatrics, mental health and primary care.
This paper discusses the currently popular approach to planning health services which is based on demand predictions. From a consideration of the demand concept, the problems of measuring present demand and forecasting future demand, it is concluded that this approach to planning will not provide health care which serves the best interest of patients, or achieves an overall efficient use of scarce resources. The development of an approach which is based on need rather than demand is seen as compatible with providing health services in the best interests of the individual as patient, and the community as tax payers.
The role of the nursing administrator in community and regional health planning and institutional program planning is illustrated. A planning systems perspective is proposed and strategies for involvement at each level are outlined. Nursing administrators who are not already involved in these phases of health care planning may be stimulated to expand their scope of participation.
Studies were made of the computed tomography (CT) scanning process at three hospitals. The data collected, while of interest to hospital administrators and radiologists, are particularly significant in view of the current structure of health planning guuielines. The data show clearly that the utilization potential of a particular CT scanner is a function of patient demand, scan time, the ratio of head to body procedures, and medical practice insofar as contrast medium administration is concerned. This paper summarizes the results of the hospital studies and documents the implications of the data for health planning guidelines.
This paper summarizes the initial phase of an effort to develop semiquantitative methods for nutrition and health planning. The general approach is to utilize the methods of systems analysis and operations research where appropriate, but the emphasis is on developing a simplified, approximate analysis that government planning groups could conveniently apply in evaluating various potential programs for attaining specific nutrition and health objectives, while satisfying certain constraints (e.g., budget, facilities, personnel). An essential element of the analysis is a model that provides an approximate description of malnutrition (inadequate growth, as indicated by weight for age) and mortality in terms of those variables that can be affected by intervention programs. We have concentrated initially on using the results of two INCAP longitudinal studies to develop models relating the incidence of malnutrition (second and third degree on the Gomez scale) to age and previous growth, including birth weight. The two studies cover rural Guatemalan communities with considerable variability in ethnic, socioeconomic, and ecological conditions. Because they are tentative, the resulting models are discussed only qualitatively and not quantitatively. The models may serve as baselines to estimate the consequences of potential programs aimed at different target groups, such as pregnant women and children whose weights at birth or thereafter fall below prescribed levels. The possible benefits of using models of this nature in nutrition and health planning are discussed.
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It is the purpose of this brief communication to examine the history of the most recently enacted health planning legislation (PL 93-641) to assess how environmental health issues were addressed and resolved during the legislative process.
This paper examines the topics of interest to a consumer advisory council in the Health Insurance Plan of Greater New York, a prepaid group practice. Data are derived from observations of consumer council meetings. Topics considered by the council dealt with (a) health plan services, (b) health plan structure, and (c) consumer council structure, process, and organizational role. The council was primarily interested in retaining and expanding existing services, facilitating utilization of services by enrollees, and achieving broader enrollee representation on the board of directors. These interests are directed toward the organizational context within which care is provided and do not relate to physician-patient encounters. Individual enrollees in prepaid group practice may be concerned with the physician-client relationship but consumer representatives are concerned only with the organization-client relationship.
It is argued in this paper that public health planning should be guided by the principle of output maximization. The objective of the health sector should be specified, and measurable forms of output should be derived from these statements of purpose. Knowledge of the contributions which given combinations of inputs make toward output thus defined allow, in principle, calculation of the particular deployment of the avilable inputs which will maximize output. There is a discussion of the objectives or forms of output in a public health system, both humanitarian and economic. A verbal model of such a system for an underdeveloped country is constructed which identifies the relationships which must be known if spending decisions are to suceed in maximizing output. An attempt is then made, in the context of the Moroccan public health system, to show that the model is not merely a theoretical exercise, but is potentially useful as a planning instrument. The respective contributions of general hospitals and of mass vaccination programs toward the objective of reducing mortality are estimated. On the whole, the preventive activities (the mass vaccinations) are found to be a much a cheaper way of saving lives than are the curative activities (the general hospitals).