Hospital Closures Rattle Small Towns

Elderly and pregnant residents are hardest hit

Across the country, more than 50 rural hospitals have closed during the last six years, and another 283 are in fragile financial condition, according to Kaiser Health News. With rural populations long in decline in the U.S., small-town hospitals have lost customers and struggled to keep pace with advancements in medical technology.

But the pace of closures has escalated in recent years, hastened by a series of budget control measures passed by Congress that reduced Medicare payments and by the Patient Protection and Affordable Care Act (PPACA), which is slowly restructuring the health care industry. The PPACA rewards scale and connectivity—difficult goals for rural hospitals that are, by their geographic nature, low-volume and remote, Kaiser says.

For many elderly residents of small towns, the price of hospital closures has been steep. When the hospital closed in Glenwood, Georgia, the remaining doctors moved out of the county, and residents now must drive two hours round trip for medical care.

For pregnant women in rural Georgia, the hospital closures can mean dwindling access to prenatal care and longer trips when labor begins. In Waynesboro, Dr. Frank Carter, a prenatal specialist, said after the troubled local hospital there closed its labor and delivery unit, his patients—largely poor women with little money for transportation—face an hour’s drive to deliver their babies.

Adjusting to that new reality is difficult for many rural residents. Hospitals are often a vital part of small-town life, said Chuck Adams, vice president of the Georgia Hospital Association.

“Towns like Glenwood have always had a hospital. When that hospital closed, then these residents immediately lost access without an opportunity to figure out what that next access model was,” said Adams. “When you have time to figure it out, I think there are models out there that could work.”

The effect of hospital closures on health outcomes remains unclear. Researchers have found that closing down a rural hospital does not increase the chance of death, and an investigation by the Wall Street Journal found that surgeries at many rural hospitals carried a greater risk of complications. For some emergencies, patients can receive better-quality care at larger hospitals that treat more cases, the Journal reported.

While rural residents need access to primary and urgent care, not every town can sustain a hospital with costly medical equipment and a roster of specialists, noted Alan Kent, chief executive officer of Meadows Regional Medical Center in Vidalia, Georgia.

“We have to be more efficient in hospitals if we are going to be sustainable, and I think that’s one of the things that you’re seeing that’s driving the consolidation in the industry,” he said.

Source: Kaiser Health News; March 10, 2016.


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