How much of what kind of health care infrastructure do we need?

In 2007, the Dartmouth Atlas published a white paper on “supply-sensitive care,” which they describe as care whose frequency of use is not determined by scientific evidence but by the health care capacity in the region. Dartmouth researchers confirmed earlier studies dating back to the 1960s and found that more care is delivered in regions where more health care resources exist, and that the extra care (and associated cost) does not result in improved health for the region. To the contrary, as we learned from our Annual Seminar on May 7, unnecessary tests and procedures expose patients to harm.

The growth in health care infrastructure – new or expanded hospitals, more technology, specialty clinics, etc. – is evident in many communities. Does this represent wise investment to accommodate the future health care needs of an aging population or over capacity that will add to our costs and put consumers at greater risk for unnecessary care? At the same time, some communities lack adequate access to primary care and basic health care services.

The Alliance Health Policy committee recently authored a resolution calling for more objective information with which to assess how much of what kind of health care infrastructure is needed – community by community. The Alliance resolves to work with other health care stakeholders to:

  • Raise awareness among purchasers, providers, health policy makers and public health officials of the need for and feasibility of a data-driven infrastructure needs assessment.
  • Encourage credible, objective, non-partisan entities, such as the Population Health Institute, the Dartmouth Institute or the Legislative Council to commit to this project.
  • Help secure necessary funding.
  • Disseminate the results and encourage their use in future health care construction planning.

We agree with the Dartmouth Researchers that concluded that information itself can make a difference, and see opportunity in the Affordable Care Act’s requirement that hospitals conduct and publish community needs assessments every three years. Adding these studies to existing data from other sources (public health departments and the Dartmouth Atlas), we can empower community planners, hospital boards and others to make informed decisions about where to invest responsibly in future health care resources.

Read the full resolution here.

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