NURSES TRY TO CHANGE THE FUTURE; REPORT LOOKS AT HEALTH CARE ACCESS

By the year 2020, a policy of rationing health care so that only the most affluent Missourians have access to high-tech medical procedures has been identified as one of two probable scenarios by a blue-ribbon panel of Missouri health professionals.

Without substantial changes, the future of health care could be disastrous, said Toni Sullivan, dean of the University of Missouri School of Nursing and the panel's leader.

This scenario is the culmination of a two-year research project looking at what the future holds for health care and where nursing fits in the picture.

The results of the study, "Missouri Nursing 2000," will be presented Friday at a state-wide conference in Jefferson City.

One of two co-principal investigators in this study is Karen Hendrickson, assistant administrator and chief nursing officer at Southeast Missouri Hospital. She hopes the future, in reality, will be much brighter.

"Nurses seek to shape and mold the future through the study process," said Hendrickson. "The futures research method is premised on the belief that the future can be influenced and shaped, that a preferred future can be articulated and planned for.

"The scenarios predict the future," Hendrickson said. "We can either buy into it or we can choose to reshape it.

"It's a new approach. But I think it shows that nurses throughout the state are really scholarly in their pursuit of where we wish nursing to be in the year 2000."

Initially, the study group compiled data about nursing and health care in the state. The information was then transformed into scenarios for the future.

To arrive at the scenarios, the project team identified 29 forecast statements that demonstrate the relationship between health-care problems, fiscal constraints and the economic and political maze providers must pass through before they can care for patients.

About 75 nurse and non-nurse health care experts then completed a series of questionnaires.

The most probable and most desirable scenario identified by the group indicates that even without reforming Missouri's health-care system by 2020, the broad advancement of technology will allow providers to predict and manage an individual's health-care needs.

Other trends could be a continued shortage of nurses well into the 21st century, spiraling numbers of underinsured Missourians and a skyrocketing demand for intensive services for the increasing elderly population.

The study also predicts wide acceptance of nurses as cost-effective primary providers of health care by both consumers and payers and predicts that competitiveness will intensify among nurses and other health professionals for scarce health care dollars.

Hendrickson said: "We believe through this study we will find a redefinition of nursing. We will continue to define the practice arenas in which nurses work.

"This research panel expects to provide the leadership in Missouri to bring about the preferred future," Hendrickson said. "Following this conference, the study group will put this information forward to the public in statewide presentations, and a book of the findings will be published. We will meet again in July to further develop an implementation plan."