Major Health issues in Washington State: report of a Delphi study Discussion Paper #4, 1977, Center for Health Services, Research Department of Health Services, SC-37, 1977

In an effort to make educational and research programs more responsive to health care needs in Washington State, the Center for Health Services Research at the University of Washington polled knowledgeable individuals from many aspects of the health services field to obtain their impressions of the critical health issues in the state. A group process, called the Delphi Technique, was used during the period of October, 1976 to February, 1977 to elicit participants opinions. A reasonable consensus among respondents concerning the important health problems facing the citizens of Washington State emerged. The following items, in order of priority, were ranked among the most important: Health care is not accessible to all residents of the state due to financial barriers, geographical barriers, maldistribution of health services and health manpower, and related factors; The cost of health services continues to increase rapidly without sufficient incentives for containment; Current patterns of health care delivery are not directed toward preventive, ambulatory, and home care; Reimbursement mechanisms perpetuate the current disorganized system for delivering health care; Health care services are not provided in a comprehensive and coordinated manner; There will be increased environmentally caused disease, from pollution, chemicals, stress, and ailments associated with the work place. Other important items were: education, coordination and planning among health and social services, response to changing patterns of disease, and inadequate measures of health outcomes. Discussion of the organizations and groups (such as health planners, university groups, third-party payers, consumer groups, providers, etc.) that may have influence or control over health problem areas is presented.