The United States Veterans Administration health care system as a model of regionalization

The regionalization of health services is fundamentally based on a system of allocation of resources. The VA appears to have adopted the philosophies of regionalization by forming a network of 28 medical care districts that share the system budgeting responsibility. This approach tends to ignore population aspects, specifically: the needs of the veterans, the interplay of medical school affiliation, the internal effects of incentives for high inpatient censuses, the effect of district leadership. A fourfold research plan is suggested, including an intense investigation of (1) the veteran population, (2) the decision-making process in resource allocation, (3) the relationship of the Va to its environment, especially the health care structure of the communities where facilities operate, and (4) the problems associated with health delivery planning and resource allocation in general.