Abstract

I NITIATION of nearly every important health measure sets off a long chain of events which focuses awareness on pre-existing, everexpanding needs. For example, when the HillBurton program was initiated in 1946, the nation's primary concern about health was hospital shortages, particularly in rural areas. As the program got underway, many societal changes which affected our healith care systemor nonsystem-began occurring. Some of the emerging needs which the HillBurton p,rogram helped spotlight were the kind of planning which would bring about coordinated interrelationships between community health facilities and services, a licensure program which, hopefully, would elevate the qualitv of institutional care, better design centered on function of the facilities, and advancement of community-based facilities for the mentally retarded and mentally ill (1). Before the enactment of Medicare, the Hill-Burton program helped to delineate the growing need for long term care facilities and nursing homes. Closely linked to the construction of health facilities is their staffing. Thus a big push was necessary to fill the growing manpower shortages in medicine, nursing, and the allied health professions. Overcoming the manpower shortage required a program di.rected to constructing additional educational facilities while recruiting students to enter the health professions. Although many others remain, only eight of the major needs of the health industry as they relate to institutions are discussed in this papler.

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