Committee Resource Allocation Process: Implications for Health Care Capital Expenditure Limits. Executive Summary

摘要

This study examines the procedural issues inherent in resource allocation by committee, a process that may arise in the context of hospital capital expenditures regulation if suggestions for area-wide capital expenditure limits are taken up. Project selection under a fixed budget is inherently different from the present certificate of need process in which the approval of one project has no effect on the ability to approve others. This study involved a review of the literature on decision-making in groups and on the experience of health planning agencies with certificate of need. The purpose was two-fold: to determine the extent to which one can predict the consequences of a CAP-CAP for the distribution of health care resources; and to summarize the impact of the process of decision-making on the outcomes. Three conclusions emerged from this review. First, the current model for representation on the Boards of Health Systems Agencies (a provider/consumer model) is a poor structure for CAP-CAP decisions. Second, the details of procedures have a strong influence on outcomes in ways that cannot always be predicted but which must be acknowledged by those who design the process. Third, the most useful support function for agency staff under a CAP-CAP would be to suggest efficient alternatives for consideration by the Committee.