Women lose access to reproductive healthcare services in almost half of the consolidations between Roman Catholic and non-Catholic hospitals, according to a new report by an advocacy group that supports the availability of reproductive services in Catholic hospitals.
Between 1990 and 1997, about 48% of those deals resulted in the loss of some, or all, reproductive services prohibited by the Catholic church, including abortions, contraception, sterilization and fertility treatments.
Those most seriously affected are often low-income women who have few or no other providers to which to turn, according to a report by the Washington-based group Catholics for a Free Choice, an independent not-for-profit advocacy group.
"In general, lower income women . . . are the ones who use hospitals as their primary source of healthcare," said Frances Kissling, the group's president. "Therefore, anything that happens in hospitals to limit services is going to disproportionately affect poor people."
The report looked at 64 of the 84 mergers and affiliations between Catholic and non-Catholic hospitals in a seven-year period. The advocacy group was unable to get information on the status of services in the remaining 20 deals.
Most recently, reproductive services were discontinued in 40% of the 10 consolidations the group had information on for last year. There were 14 total Catholic with non-Catholic deals in 1997.
In 1996 the group found services cut in 53% of the 17 deals for which it had information. That year saw a total of 24 consolidations.
"Without strong advocacy for the preservation of reproductive health services, more communities nationwide will see these services eliminated," the report concludes.
A spokesman for the Catholic Health Association said the organization couldn't comment because it had not read the group's report.
The report is based primarily on interviews and news media accounts.
In its 69-page report, Catholics for a Free Choice warned the threat to reproductive services will grow right along with Catholic integrated delivery networks.
The coming together of HMOs, doctors and hospitals under a Catholic umbrella can further constrain patient access.
"Catholic hospitals are merging . . . because they create a stronger economic and geographic entity to bid for managed-care contracts," Kissling said. "Then, they get managed-care contracts with the government and employers, and people then find their choices are restricted by the rules of the Catholic hospitals."
The loss of services might be felt most acutely in rural areas where a Catholic facility is the sole provider.
The debate over reproductive services is complicating a proposed mergerlike partnership of three hospitals in New York's mid-Hudson Valley region (Feb. 16, p. 24).
While the Federal Trade Commission is concerned the deal could create an acute-care monopoly, local residents are up in arms over the potential loss of reproductive services.
Cross River HealthCare's two secular hospitals have agreed to Catholic prohibitions on reproductive services as part of its proposed partnership with 222-bed Benedictine Hospital in Kingston, N.Y.
