How hospital closures affect surviving facilities

Healthcare leaders can learn much from long-term patterns in hospital closures, according to a study published in Health Affairs.

Between October 2011 and January 2012, researchers interviewed 23 employees at hospital obstetric units in Philadelphia County that remained open between 1997 and 2012, a period when 13 of 19 obstetric units closed, to determine the effect of the closures on their operations.

The researchers, led by Scott A. Lorch, an associate professor of pediatrics at the Children's Hospital of Philadelphia, identified several themes in the interviews, including:

  • Economic challenges within the field as a major driver of unit closures and struggles within the surviving units

  • Chronic stress within the system due to the alterations in patient demographics and volumes the closures caused

  • The necessity of an unplanned "ad hoc response" to these changes within the obstetric units that remained open

As a result of these changes, "many informants reported that 'we are seeing some people with no prenatal care. We are seeing some people who said they had care elsewhere and when we called elsewhere, wherever that may be, they either could not locate their record or told us that there was no care provided there,'" the study states. "Care became more inefficient, which worsened the effects of surges in delivery volume."

Despite the problems caused by these closures, some healthcare experts believe hospital closings may be necessary for the recovery of the industry. Simply put, the U.S. has too many hospitals, Cleveland Clinic CEO Toby Cosgrove said during a July panel discussion, FierceHealthcare previously reported. Two decades ago, Cosgrove said, there were one million hospital beds in the U.S., whereas today that number has fallen 20 percent and there are still more beds than hospitals can fill, with total occupancy at only 65 percent.

To learn more:
- here's the study abstract

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