Continued closures of rural hospitals — more than 50 have closed in the last six years and 283 more are listed as being in fragile financial condition — is costing small towns much needed jobs and putting residents in the unenviable position of needing to drive long distances to see doctors or seek emergency care, Sarah Varney reports for Kaiser Health News.
"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 Affordable Care Act, which is slowly restructuring the health care industry," she writes. "The law rewards scale and connectivity—difficult goals for rural hospitals that are, by their geographic nature, low-volume and remote. Compounding their financial troubles, 19 states have not taken advantage of a key provision in the health law to expand their Medicaid programs. That’s left many rural hospitals with uninsured patients just as federal subsidies for taking care of the uninsured are being reduced."
The effect of hospital closures on small towns like Glenwood, Ga. (Best Places map: Glenwood has about 700 residents) has been devastating, Varney writes. Lower Oconee Community Hospital, which recently closed, "was the town’s largest employer and without the daily traffic from its 100 employees and families and friends of its patients, the town’s only restaurant closed, followed soon by its only bank." D.K. Patel, owner of the local grocery store, told Varney, “After the hospital closed, we dropped about 30 percent sales. All I can say is it’s been hurting a lot.” In addition to losing jobs, the hospital closing has forced residents to drive hours 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," Varney writes. "In Waynesboro, Ga., 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."
"But while hospital closures in rural areas can unsettle residents’ nerves and force them to travel farther distances, the effect on health outcomes remains unclear," Varney writes. "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 surgeries at many rural hospitals carried a greater risk of complications. Indeed, for some emergencies, patients can receive better quality care at larger hospitals that treat more cases."
"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 Affordable Care Act, which is slowly restructuring the health care industry," she writes. "The law rewards scale and connectivity—difficult goals for rural hospitals that are, by their geographic nature, low-volume and remote. Compounding their financial troubles, 19 states have not taken advantage of a key provision in the health law to expand their Medicaid programs. That’s left many rural hospitals with uninsured patients just as federal subsidies for taking care of the uninsured are being reduced."
"For pregnant women in rural Georgia, the hospital closures can mean dwindling access to prenatal care and longer trips when labor begins," Varney writes. "In Waynesboro, Ga., 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."
"But while hospital closures in rural areas can unsettle residents’ nerves and force them to travel farther distances, the effect on health outcomes remains unclear," Varney writes. "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 surgeries at many rural hospitals carried a greater risk of complications. Indeed, for some emergencies, patients can receive better quality care at larger hospitals that treat more cases."
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