Inappropriate Number of Hospital Beds Planned by Veterans Administration for Chicago Area

The North Chicago Veterans Administration (VA) hospital was constructed in 1925 as a long-term neuropsychiatric facility with supporting medical and surgical capability. Since 1974, the hospital has attempted to expedite the return of psychiatric patients to the community and, concurrent with the reduction in the number of psychiatric beds, the hospital has taken steps to upgrade and expand its general medical and surgical role in VA Medical District 17. An affiliation was proposed with the University of Chicago Medical School. The transfer has not occurred, however, because the Department of Health, Education, and Welfare questioned the propriety of the university's proposed relocation and the efforts of the VA to transfer land to the university. The hospital's plan to expand its acute-care capability was not based on demonstrated need; instead, it was based on the assumption that expanded capability would lead to increased demand for acute-care beds. The hospital's plan did not recognize the availability of existing acute-care medical and surgical beds at three other VA hospitals in the Chicago area. These beds are more than will be needed to meet projected 1985 acute-care requirements for the area. VA is planning too many acute-care beds and too few long-term-care beds for the Chicago area. The Administrator of Veterans Affairs should: (1) suspend further expansion of the acute-care capabilities at the North Chicago VA hospital; (2) reduce the number of acute-care beds at the hospital and redistribute them as necessary for long-term care; and (3) reduce the number of acute-care beds at the other three VA hospitals and redistribute them as necessary for lower levels of care.