Editor’s Note: On Thursday, citizens, hospitals, schools, community leaders and healthcare providers will observe National Rural Health Day. The national observance was formed in 2011 from the National Organization of State Offices of Rural Health to improve awareness of rural health issues and bring national recognition to the significant work of rural healthcare providers, State Offices of Rural Health and other rural stakeholders.
Roughly 1 in 5 Americans–62 million in total–live in rural areas and receive healthcare from rural providers. The closing of a rural healthcare facility is a community tragedy, affecting residents, caregivers, employers and the community at large. The implications for individuals in diminished access to timely, quality care are evident. Individuals residing in or near the poverty line who receive crucial providers from rural hospitals lose a vital safety net.
A troubling tendency
The North Carolina Rural Health Research Program (NCRHRP) at the Cecil G. Sheps Center for Health Services Research, which monitors rural hospital closures, reported which 72 rural hospitals closed between January 2010 and April 2016, in contrast to 42 closures between 2005 and 2009. Since the 2008-2009 recession, the annual number of closures has increased each year. A lot more are vulnerable to closure.
“When I arrived at the hospital 11 months before, it had been on the brink of closed and employees worried about their paychecks clearing.”
Even the NCRHRP interviewed stakeholders about the effect hospital closures are getting on their communities. According to an April 2015 short (PDF) from NCRHRP, many rural residents aren’t receiving needed tests or care due to lack of transportation to get the services. Diagnostics tests and scans were the most commonly identified services which currently required travel after the rural hospital shut.
Additional findings included:
- Average traveling space to other locations was 25 miles from the closed hospital’s address. Some other locations have been in neighboring countries
- Major and complex treatments like dialysis, cancer therapies and treatment for catastrophic injuries were also an issue
- Total, an increased space to healthcare is regarded as an issue for members of these communities
Less-obvious effects of hospital closings will be the potentially devastating consequences on the wider community if a hospital closes. Often, the local health facility is the biggest company. The National Center for Rural Health Works reported (PDF) the overall financial effect of a typical Critical Access Hospital is 195 employees and $8.4 million in payroll. A study from the National Institutes of Health discovered that the close of a rural hospital reduces per-capita income by an average of 703 and raises the neighborhood unemployment rate by 1.6 percent.
In survival mode
To combat, rural hospitals are learning just how to survive in a shrunken economy. Many now must reset the expectations of their communities about what services they could provide and stay viable.
“When I arrived at the hospital 11 months before, it had been on the brink of closed and employees worried about their paychecks clearing,” said Charles Lovell, CEO of Barbourville ARH Hospital at Knox County, Kentucky.
First, the hospital’s leaders conducted a comprehensive needs assessment and fulfilled members of the community to determine what was needed to satisfy up with the community’s needs. Following strategic planning sessions, they decided to enlarge the hospital’s services. So they worked with sister hospitals to bring in specialists, additional speech-language therapy, occupational and physical therapies and created an outpatient psychiatric day program for elderly patients.
“I am proud to say I think we have turned the corner. You can not set a cost on being there for a patient having a seizure or a heart attack. It’s important for rural physicians to recall their range of practice–to give decent quality primary care,” Lovell said.
In many areas of the country, especially the South, many rural colleges have closed. At the town of Edgefield, South Carolina, however, Edgefield County Hospital is one of those still providing good care to the local community thanks in part to an affiliation agreement with Self Regional Healthcare, a large nonprofit hospital at Greenwood.
“Lots of hospitals in rural regions don’t survive because they don’t replace family practice doctors who depart the community or retire, and when they leave that’s normally when the hospital fails,” stated Edgefield County Hospital CEO Carlos Milanes. ” We were looking for strategies to enhance services we supply locally, and we partnered with another supplier to do our goal and stabilize family training doctors in our area.”
The affiliation enables Edgefield to participate in a more group-purchasing plan which offers significant savings on medical equipment and pharmaceuticals. The clinic also works closely with the South Carolina State Office of Rural Health, which frequently shares information about best practices and updates on legislative initiatives. Lately, the hospital was able to amuse a family physician from Self Regional’s Family Practice program, thereby eliminating costly recruiting charges.
“Valuable collaborations like this help save dollars and keep us viable,” Milanes stated.
Collaboration is a key function of each of the 50 State Offices of Rural Health, many of which are celebrating more than 25 decades of service this past year. With proactive direction and targeted technical assistance, vulnerable communities and hospitals might have the ability to prevent closure by adopting innovative methods of caring for their taxpayers.
National Rural Health Day is a time for all of us to know from the innovative work of those hospitals and providers which are flourishing in rural America. Find out more about rural health by adhering into webinars Thursday.
Teryl Eisinger is the executive director of the National Organization of State Offices of Rural Health, a national nonprofit membership organization that represents the 50 State Offices of Rural Health around the nation. A longtime healthcare professional, Eisinger has worked in rural health and wellness promotion for underserved populations for the last twenty decades.
Hospital Impact, Rural Healthcare, Preventive Medicine, Safety-Net Hospitals, Fierce Exclusive, Population Health, Teryl Eisinger, National Organization of State Offices of Rural Health, Carlos Milanes, Personal Regional Healthcare, Edgefield County Hospital, Charles Lovell, Barbourville ARH Hospital, National Center for Rural Health Works
source http://www.livingwithfibroblog.com/hospital-impact-how-rural-hospital-closings-weaken-the-nations-health/
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