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Jan 2015

Where Have All the Hospitals Gone?

Determining the right number of hospitals in any given community in the United States presents a conundrum for healthcare experts. Some contend there are too many hospitals leading to low occupancy rates, consolidation and closures. Others maintain that we have too few hospitals and we are endangering patients who have to travel long distances for care. Researchers from UC San Francisco have found a correlation between emergency department closures and increased patient mortality rates at nearby hospitals which could indicate that we may not have enough of the right type of hospitals.

Nevertheless, hospitals are closing around the county. This presents problems for the patients, employees and the community. The winding down and transfer of patients to other hospitals as well as what to do with the physical hospital and real estate are real challenges. The reasons for this trend in hospital closures are varied and are due in part to shrinking inpatient activity, increasing reimbursement rates, and changing delivery patterns.

There should obviously be great concern about this issue because hospital closings can adversely affect local economies given their status as major employers. More importantly though are the types of hospitals that are closing. Specifically, the hospitals that predominantly care for the uninsured or Medicaid populations are the most vulnerable for closure. On a more positive note, hospital closures may very well help to facilitate medical mergers and acquisitions, which can result in making things better for hospital personnel and patients in the long run. Hospital closures can also afford opportunities to improve the integration of care and realign delivery capacity in tune with what the community needs. Hopefully, this will present the hospitals with the opportunity to focus on what the community demands and what the hospital can best provide..

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