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18 Level 18 points additionally Altman analysis application Arbor area hospitals assumption board eligible specialists capabilities of Category capture tertiarity clinical services Commonality Index community general hospital community hospitals complex concept of tertiarity consultation and services demand characteristics Demand Level demand side characteristics diagnoses dimensions of tertiarity Disease explore Facilities future study Heldt Hospital Administration Ibid ilson imply initial institutions involvement Johnston Lain Hospital Laves level three limitations literature review measure of hospital medical centers medical record methodology number of patients number of services pa_e pharmacy physicians points 2 x potential predominant approach presented problems Psychiatric Hospital Radiology rarity referral require revised framework scale score September 25 service area service specific framework services provided staff stipulation seven structure supply and demand supply side characteristics Thoracic surgery tical treated University Hospital University Hospital's University of Michigan usinj v.as v/ould variable variation