La. Admin. Code tit. 48 § I-10503

Current through Register Vol. 50, No. 9, September 20, 2024

Section I-10503 - Priority Selection Methodology

A. The three issues of High Costs of Health Care, Alternatives to Long-Term Institutionalization and Health Promotion were determined to represent the priority health needs of Louisiana upon completion of the following priority selection process.

B. To facilitate the submission of recommendations respecting priority health issues, a mail-out survey was designed and sent to 1,576 individuals representing governmental health agencies, a wide range of public and private health care providers, consumer health advocacy organizations, the governing boards of the three Health System Agencies and the Statewide Health Coordinating Council. A listing of the individuals and groups surveyed can be found in Form A in the Appendix. The survey design involved presenting as many potential priority topics as could be identified to the surveyed population and requesting that they select the ten topics they believed most important. The ten topics were then to be ranked by respondents from one to ten in the order of priority they would assign. Respondents were asked to consider priority selection in the following ways:

1. Impact on Population of the State

a. The number of people and the degree to which the state as a whole is affected.

b. The pain, disability, discomfort or early death caused to the individual citizen.

2. Potential for Elimination-Benefits. The probability that substantial prevention, reduction or elimination of the problem can occur if something is done about it.

3. Future Impact-Urgency

a. The degree to which this problem will affect the state and its citizens if no changes are made in the health care system.

b. The total costs to the individual, the community and the state that will be incurred in the 1982-1987 period if something is not done.

C. In developing the list of possible priority areas for the survey, the Health Planning and Development Agency compiled a list of health issues which included:

1. national health planning priorities;

2. health systems agencies priorities;

3. leading causes of death in the state;

4. leading causes of morbidity in the state, indicated by hospital discharge diagnoses and statistics on communicable disease; and

5. qualitative statements about possible deficiencies in the state's health system resources in the areas of availability, accessibility, cost, quality or continuity of services.

D. This comprehensive list of issues was reduced to the twenty-two issues presented in the survey after related issues were grouped into broader issues and some issues were discarded because of a failure to meet the requirement of (a) broadness of scope; or (b) capability of DHHR to address the issue effectively; or (c) urgency of the problem because of a lack of current resources and a likelihood of a worsening in the status quo. In addition, the HSA's were given the opportunity to review and suggest recommendations which were incorporated into the survey. Refer to Form B in the Appendix for a copy of the survey and priorities.

E The survey also gave respondents the opportunity to write in additional priority areas of concern so that it could be determined if any major areas had been overlooked. Essentially, the State Health Planning and Development Agency is satisfied that the possible priority issues presented for consideration by respondents was comprehensive and represented significant health-related issues in Louisiana. Refer to Form C in the Appendix for a review of the comments received from respondents.

F. Nine hundred forty-six of the 1,576 surveys were returned. This represented 60 percent of the surveyed population, which is a statistically sound sampling. Surveys were returned from people in every parish of the state: 53 percent were public providers of health care; 20 percent were private providers and 27 percent classified themselves as consumers of health care. Residential distribution was 41 percent from rural areas or cities under 25,000; 21 percent from cities, population 25,000-100,000; 20 percent from cities, population over 100,000; and 18 percent from the New Orleans Metropolitan area. Female respondents comprised 53.5 percent; males 46.5 percent. Blacks comprised 8 percent of the respondents; Whites 91 percent; other, less than 1 percent. Age distribution of respondents was 5 percent age 65 + ; 84 percent age 31-64; and 11 percent age 18-30.

G. Respondents' answers were tabulated in two methods. Priorities were assigned a point value of ten for a first place ranking, down through one for a tenth place ranking. Results were then recomputed giving no value for a ranking of six to ten and assigning a value of five for a first place ranking and so on down to a value of one for a fifth place ranking. These two methodologies were used in order to compare any difference in ranking which might occur due to a particular issue being selected by a large number of people as a priority ranked 6-10 but by relatively fewer as a priority 1-5. This was considered significant since it was proposed that priority issues be limited to a small number which could be given significant attention.

H. The outcome of the rankings appears on Form D in the Appendix. It is noteworthy that the position of "Substance Abuse" falls from #5 to #12 when only the top five priorities were tabulated. Otherwise, the rankings remained relatively stable.

I. The Health Planning and Development Agency recommended that the top three issues selected by survey respondents be accepted as priority health issues for focus during the 1982-87 planning horizon: High Costs of Health Care, Alternatives to Long Term Institutionalization, and Health Promotion. These three issues were adopted by the Statewide Health Coordinating Council as the statewide health needs deserving priority attention in the development of health-related planning by all concerned private and public organizations and provider groups. The Department of Health and Human Resources also adopted these three issues as their planning priorities for the 1982-87 period.

La. Admin. Code tit. 48, § I-10503

Promulgated by the Department of Health and Human Resources, Office of Management and Finance LR 13:246 (April 1987).

AUTHORITY NOTE: Promulgated in accordance with P.L. 93-641 as amended by P. L. 96-79, and R.S. 36: 256(b).