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Hospital closures have been a point of trepidation in the healthcare community, as leaders worry whether patients will have access to needed care. But a recent Health Affairs study shows that things may not be as bad a previously thought.
Researchers from Harvard School of Public Health found “no significant change” in mortality rates of Medicare patients between areas with one or more hospital closures, and areas that experienced no closures. The study looked at 195 hospital closures between 2003 and 2011 and analyzed mortality rates in the year before and the year after the closures. There was also no significant difference in all-cause mortality rates after hospitalization – in fact, readmission rates dropped in areas with hospital closures (from 19.4% to 18.2% vs. controls). The researchers found that 70% of the closures occurred in urban areas, rather than rural areas. One-third of the closures were safety net hospitals. “Overall, we found no evidence that hospital closures were associated with worse outcomes for patients living in those communities,” the authors stated.
There are a few limitations: The study data were restricted to mortality rates of Medicare beneficiaries, rather than the entire patient population, and also looked mainly at averages. The study also looked at urban and suburban areas with a larger supply of hospitals than a more rural area.
While the study might give some measure of comfort about the effects of closures on patient populations, there still should be increased focus on areas that might be in worse shape if a major hospital shuts down. The boom in urgent care centers and standalone emergency rooms can ease some of the pain, but cannot entirely replace all hospital services.