The impact of hospital closures on their communities

This month, Independence, Kansas' Mercy Hospital announced it will close its doors, making it the 58th rural facility in America to do so since 2010, leaving the community where it was a longtime institution to reassess its options, the New York Times reports.

The 75-bed facility, which served a population of 9,000, was, like most of the closures, a midsize facility rather than a critical access hospital. Once it became clear the hospital was in imminent danger of closing, there was speculation the state's Republican-dominated legislature would reconsider its opposition to expand Medicaid under the Affordable Care Act, but Gov. Sam Brownback maintained his opposition.

The hospital had been a community institution for over a century, and saw roughly 8,000 emergency room patients a year, according to the article. A hospital spokesperson said another provider tentatively committed to opening an urgent care clinic to provide care for Mercy's former patient population, but this is unlikely to offset the economic fallout of the closure within the community. Businesses will be less likely to come to a town with no local hospital, and the fire department has purchased an additional ambulance, anticipating longer travel times for emergencies.

Such closures' effects on community health are harder to pin down; a May study published in Health Affairs found hospital closures do not hurt a community's healthcare outcomes, which the authors speculated may be due to the facilities that closed providing lower-quality care in the first place.

Rural hospitals in numerous other states have faced similar crises and threats of closure, and not only in non-expansion states. Last year a Massachusetts community hospital closed with three days' notice, leaving its patients with the prospect of crossing the state line into Vermont for care. Meanwhile, in another non-expansion state, North Carolina, Franklin Medical Center, recently closed, but its former patients still have options, as 90 percent of them sought care outside the country anyway, argues an opinion piece in the News & Observer, echoing the Health Affairs study.

To learn more:
- read the Times article
- here's the News & Observer article

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