Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

If your hospital closes, does patient care suffer?

Brad Wright, PhD
Policy
June 23, 2015
9 Shares
Share
Tweet
Share

In many communities around the country, hospitals are one of — if not the — largest employers. Consequently, there are undoubtedly economic issues that would befall an area if its hospital were to close. But this post isn’t about that. It’s about the health care consequences, and by extension, the health consequences that might arise in a community when a hospital closes its doors.

The logic is fairly straightforward: If a hospital closes, it reduces access to certain types of care. If access to care is reduced, people’s health is likely to suffer. Like many of the things I choose to write about, however, there’s the big gap that exists between intuitive thinking and empirical evidence.

Fortunately, Karen Joynt and colleagues recently published a study in Health Affairs that helps to fill that gap. Specifically, they looked at nearly a decade worth of data on hospital closures nationwide between 2003 and 2011. Then they explored whether hospitalization rates or mortality rates were associated with these hospital closures. Surprisingly, they “found no evidence of an association between hospital closures and worsening outcomes for those living in the local community.” In fact, they found that hospital closure was possibly associated with a small reduction in readmission rates, which is a good thing.

Since this data-driven analysis seems to run contrary to what we might assume we’d observe, the next question to ask is: What does it mean?

The authors offer two distinct possibilities. First, they suggest that as long as the hospitals that closed were low-quality hospitals, then it would make sense that outcomes wouldn’t suffer. And, related to that, it would actually be a net positive, because people who were going to the low-quality hospital would now be redirected to a higher quality hospital after the other hospital closed.

Of course, that assumes that there is more than one hospital accessible to the community experiencing the closure. If the next closest hospital is a considerable distance away, then that travel barrier may reduce access and offset what would otherwise be an improvement in health care quality.

Second, they suggest that areas experiencing a closure had an oversupply of health care providers, meaning that a closure could occur without restricting access, because the local health care system would still have adequate capacity to provide needed care.

Both explanations really point towards hospital closures being the natural consequence of a well-functioning market. That’s great news, unless you happen to work at a hospital that’s closing, in which case it’s probably very little consolation.

However, that underscores the bigger lesson here: We spend far too much money on health care in this country. Contracting the size of the health care industry to save money can be done in ways that increase efficiency and don’t harm patient outcomes, but that is no guarantee that employees of the health care sector won’t be directly — and negatively–affected. After all, what some call health care expenditures, others call income. And that maxim is precisely what has made meaningful health reform and cost-control efforts so difficult.

Brad Wright is an assistant professor of health management and policy, University of Iowa, who blogs at Wright on Health.

Prev

Patient information is growing up. It's now entering adolescence.

June 23, 2015 Kevin 0
…
Next

Managing your health is difficult on a student's budget

June 23, 2015 Kevin 3
…

Tagged as: Hospital-Based Medicine, Public Health & Policy

Post navigation

< Previous Post
Patient information is growing up. It's now entering adolescence.
Next Post >
Managing your health is difficult on a student's budget

More by Brad Wright, PhD

  • a desk with keyboard and ipad with the kevinmd logo

    We have the power to prevent disease. But we’re not using it.

    Brad Wright, PhD
  • a desk with keyboard and ipad with the kevinmd logo

    The uninsured rate has fallen, but it may soon rise

    Brad Wright, PhD
  • a desk with keyboard and ipad with the kevinmd logo

    CVS removes tobacco products: Did they go far enough?

    Brad Wright, PhD

More in Policy

  • Healing the damaged nurse-physician dynamic

    Angel J. Mena, MD and Ali Morin, MSN, RN
  • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

    Mohammed Umer Waris, MD
  • Breaking down the barriers to effective bar-code medication administration

    Amy Dang Craft
  • The locums industry has a beef problem

    Aaron Morgenstein, MD
  • Canada’s health workers are sounding the alarm. We must act, now.

    Ivy Lynn Bourgeault, PhD
  • Race categorizations are worsening health inequities for the South West Asian North African (SWANA) communities

    Guleer Shahab, MPH
  • Most Popular

  • Past Week

    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • From physician to patient: one doctor’s journey to finding purpose after a devastating injury

      Stephanie Pearson, MD | Physician
    • An unspoken truth about non-compete clauses in medicine

      Harry Severance, MD | Policy
    • Fostering the next (diverse) generation of clinicians

      Imamu Tomlinson, MD, MBA | Physician
    • Healing through love and spirituality

      John T. James, PhD | Conditions
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Why are doctors sued and politicians aren’t?

      Kellie Lease Stecher, MD | Physician
  • Recent Posts

    • Rescuing primary care: the role of health administrators [PODCAST]

      The Podcast by KevinMD | Podcast
    • Breaking down barriers: How technology is improving diabetes management in underserved communities

      Anonymous | Conditions
    • From penicillin to digital health: the impact of social media on medicine

      Homer Moutran, MD, MBA, Caline El-Khoury, PhD, and Danielle Wilson | Social media
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • How to overcome telemedicine’s biggest obstacles

      Harvey Castro, MD, MBA | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 3 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Investigational ALS Drug May Have Clinical Benefit, FDA Staff Says
  • Cases of Deadly Fungus Tripled in Past Few Years, CDC Says
  • Small Gains in Cardiorespiratory Fitness Track With Improved Longevity
  • Improved OS With Hyperfractionated RT in Recurrent Nasopharyngeal Carcinoma
  • GPT-4 Is Here. How Can Doctors Use Generative AI Now?

Meeting Coverage

  • Rapid Improvement in Atopic Dermatitis With Topical PDE4 Inhibitor
  • New Approaches in the Bladder-Sparing Paradigm
  • Response Rates in Hidradenitis Suppurativa Continue to Climb With New Therapies
  • Another Win for a JAK Inhibitor in Alopecia Areata
  • Biologic Switch Revs Up Response in Plaque Psoriasis
  • Most Popular

  • Past Week

    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • From physician to patient: one doctor’s journey to finding purpose after a devastating injury

      Stephanie Pearson, MD | Physician
    • An unspoken truth about non-compete clauses in medicine

      Harry Severance, MD | Policy
    • Fostering the next (diverse) generation of clinicians

      Imamu Tomlinson, MD, MBA | Physician
    • Healing through love and spirituality

      John T. James, PhD | Conditions
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Why are doctors sued and politicians aren’t?

      Kellie Lease Stecher, MD | Physician
  • Recent Posts

    • Rescuing primary care: the role of health administrators [PODCAST]

      The Podcast by KevinMD | Podcast
    • Breaking down barriers: How technology is improving diabetes management in underserved communities

      Anonymous | Conditions
    • From penicillin to digital health: the impact of social media on medicine

      Homer Moutran, MD, MBA, Caline El-Khoury, PhD, and Danielle Wilson | Social media
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • How to overcome telemedicine’s biggest obstacles

      Harvey Castro, MD, MBA | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

If your hospital closes, does patient care suffer?
3 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...