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HRD-82-122 1 (1982-09-29)

handle is hein.gao/gaobabmpv0001 and id is 1 raw text is: UNITED STATES GENERAL ACCOUNTING OFFICE NO, WASHINGTON, D.C. 20548 IUMAN RESOURCES September 29, 1982 0IVISION B-209177 The Honiorable Richard S. Schweiker The Secretary of Health and Human Services 119624 Dear Mr. Secretary: Subject: Opportunity to Avoid Construction at Certain IHS Hospitals (GAO/HRD-82-122) The Indian Health Service (IHS), a component of the Department of Health and Human Services (HHS), is responsible for providing comprehensive health services to American Indians and Alaskan Na- tives. In carrying out this responsibility, IHS operates 49 hos- pitals, 102 health centers, and 300 smaller health stations and satel'lite clinics. To supplement its health delivery system, IHS also obtains health services through contracts with community hospitals, private physicians, and other health professionals. In fiscal year 1982, IHS planned to spend about $397 million to operate its direct health delivery system and another $118 million to purchase health services through contracts. We reviewed the factors that contributed to the low utiliza- tion of inpatient services of nine small IHS hospitals and evalu- ated whether other cost-effective alternatives existed. At the time of our review, HHS plans called for significant capital ex- penditures to replace or modernize the facilities we reviewed. The results of our review are presented below. CONCLUSIONS AND RECOMMENDATIONS At the nine hospitals we reviewed, the inpatient workload was low, and the services offered were limited when compared to those generally available at nearby community hospitals. Because of limited IHS inpatient services, a portion of the inpatient work- load at the hospitals reviewed is now being referred to nearby conmunity hospitals, which generally have the capacity to absorb the nine hospitals' total inpatient workload. HHS plans to replace or modernize seven of the nine hospitals reviewed at a total estimated cost of $66 million. In addition, an estimated $6 million is planned to correct structural deficien- cies at all nine hospitals, and $15 million is planned for con- struction of personnel quarters at four of them. (102059) 013 S1

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