It is difficult to agree on what the current standard hospital bed utilization rate should be. The Hill-Burton program, which is responsible for hospital development, has long used a bed occupancy rate of 85 percent to determine the need for additional hospital beds. The U.S. National Health Plan guidelines set a minimum average bed occupancy rate of 80% for general hospitals, 75% for obstetrics, and 65-75% for pediatrics, depending on size. Bed occupancy rates vary considerably from state to state, depending on size or equipment. However, bed utilization standards are critical to hospital planning. Hospitals can expand or maintain their number of beds based on their actual or expected bed utilization. Planning and management also determine overall bed needs based on bed utilization. For example, one state requires hospitals with more than 150 beds to have an occupancy rate of more than 92 per cent before expansion is permitted. Another state includes a minimum bed utilization rate in setting reimbursement for hospital care. The bed occupancy rate in China's domestic public hospitals is generally above 85%, with tertiary hospitals generally reaching over 90%. Private hospitals are generally below 80 percent, with the worse only around 50 percent.