After the abrupt closure of 160-year-old St. Vincent's Hospital in New York City in 2010, dislocated patients flooded nearby hospitals. The disruption made the community an appealing case study for researchers at the UPMC Center for Health Security in Baltimore, who examined the Manhattan hospital's closure for clues into how a sustained swell in demand might affect other hospitals.
Hospitals near St. Vincent's—a Level 1 trauma center and safety net hospital—scrambled to find space and staff. Hospitals added workers in psychiatry, speeded up physician credentialing, added triage and patient-care units, and placed patients in beds in the hallways.
Hospital closures typically cause upheaval among the patients, communities and other providers in the market. It is less clear, however, whether the closures result in worse health outcomes for the community.
Now, an ambitious new study in Health Affairs by other researchers suggests that based on broad measures of quality and access, patients collectively may be no worse off—and some types of patients may fare better with different providers.
The Health Affairs researchers, who examined 195 hospital closures between 2003 and 2011, found the death rate for Medicare beneficiaries in affected communities was no different following the closures, even among people who were recently discharged from a hospital. The cost of care and the length of hospital stay also were no different. That was largely true even when the researchers looked at patients who needed immediate medical attention, such as patients with trauma, stroke or heart attack.
Remarkably, fewer patients in communities with closed hospitals died from heart attacks. Beyond that, fewer Medicare patients returned to the hospital within 30 days of leaving. And when the only hospital to serve a community closed, death within 30 days of hospitalization in that community declined.