By EDNA McCONNELL
Formerly staff writer for the Danville, Illinois, Commercial-News, she was editor of the Georgetown News and its two subsidiaries, the Catlin Courier and the Westville News, and served a resident internship with the Illinois State Register. She holds an M.A. degree in Public Affairs reporting from Sangamon State University.

Hospital building control: answer to rising costs?

How many hospital beds does Illinois require? And where should they be located? Under new legislation all decisions regarding expansion of health care facilities will be made by the Comprehensive State Health Planning Agency

"MORE HOSPITALS TO FILL: ABUSES GROW" "DON'T PLAN ANY NEW HOSPITALS, EXECURGES" "HOSPITALS: DO WE NEED MORE?"

All these headlines appeared in newspapers and journals late last spring. Even the casual reader was aware that health care professionals were sounding alarms about the increase in hospital and nursing home facilities.

Nationwide, it was said, only seven per cent of available beds were in use at any given moment. Yet in parts of Illinois, like many other places, beds are still in short supply. A 72-year-old Danville woman became desperately ill in Florida but refused to be hospitalized so far from home. When she returned home, she was admitted to a hospital and diagnosed as having pneumonia. Her only hospital accommodations were a bed and table — in the hall. Hardly ideal for a patient in her condition. A young reporter in Springfield laughed incredulously at the reported surplus in hospital beds. "I've been trying for over a month to get my grandmother into a hospital," he snorted.

Even so, a few months later, a Central Illinois Health Planning Council Task Force recommended that the Comprehensive State Health Planning Agency (CHPA) deny the proposed addition of 144 beds at a Springfield hospital, citing a "surplus" of hospital beds in the region as the reason. In July 1973, the Council also advised the CHPA that it was opposed to the construction of a new hospital in Springfield for the same reason.

Costs up 500 per cent
Planning agencies and existing facilities so effectively insisted that the construction of hospitals and other health care facilities was on a runaway course, that in June 1974 the General Assembly passed Senate Bill 1609 which provided that no new facility could be built and no existing one modified without the approval of the CHPA. Sen. Jack T. Knuepfer (R., Elmhurst) sponsored the legislation and Rep. William L. Kempiners (R., Joliet) guided it through the House. When Gov. Dan Walker signed the bill into law in August he noted that Illinois had 9, 806 hospital beds more than were actually needed. "It costs two-thirds as much to maintain an empty bed as an occupied one," the Governor said, "and the costs of unused facilities are spread among paying patients."

And pay they do. Hospitalization costs have risen 500 per cent since 1964. Nationwide, the mean patient cost per diem is $115. Fortunately, the patient seldom pays the full freight. In most cases there is a "third party" payment from insurance, Medicare, or Medicaid. The "edifice complex" of administrators, and the efforts of various communities to out-build and out-equip other area hospitals, gets most of the blame for the spiralling hospital costs from professionals in the health care field.

George A. Lindsley, associate director of regulation and legislation for the CHPA, cites Bloomington as an example of runaway building. "Three hospitals there competed for patients until they agreed that it would be financially more advantageous for each to concentrate on specific services and eliminate others," Lindsley said. "Now one admits all the obstetrical patients, one all the pediatrics, etc." Even this has not eliminated underusage of facilities. Ann Anderson of WCIA-TV, Champaign, reported in October that St. Joseph's hospital in Bloomington had a 58 per cent bed occupancy rate. With 61 or 62 per cent occupancy, St. Joseph's administration believed it could maintain financial solvency, but it felt that 75 per cent occupancy would be undesirable since it would require the addition of more employees.

Surplus of beds and higher costs —related?
The expansion of hospitals and the surplus of available beds has been accepted by a majority of those in the health care field, but there is little agreement on the effects of this surplus on the cost of health care. New York State, for example, has placed a three-year moratorium on new hospital con-

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