A study of central-city hospital changes

Area of Science:

• Healthcare Management
• Public Health Policy
• Hospital Administration

Background:

• Hospital capacity and service availability are critical components of healthcare systems.
• Understanding trends in hospital bed and service changes is essential for policy planning.
• Previous analyses may not fully capture the extent of hospital closures and expansions in major urban centers.

Purpose of the Study:

• To quantify the reduction in hospital capacity in large U.S. cities between 1976 and 1978.
• To analyze the addition of hospital beds and services during the same period.
• To assess the alignment of these changes with the perspectives of Health System Agencies (HSAs).

Main Methods:

• Analysis of hospital bed and service data across 36 large U.S. cities from 1976 to 1978.
• Tracking the number of hospital bed closures, emergency room closures, and outpatient facility closures.
• Reviewing Health System Agency (HSA) approval rates for hospital closures and expansions.

Main Results:

• Over 5,000 hospital beds were closed, representing a 2.7% decrease in total beds across surveyed cities.
• Nearly half of the cities experienced no bed reduction, while seven saw reductions exceeding 5%.
• Thirty-one emergency rooms and 13 outpatient facilities were also closed, potentially impacting patient access; HSAs approved most closures (73.4%) and expansions (54.4%).

Conclusions:

• Significant hospital capacity reduction occurred in large U.S. cities between 1976-1978, with notable closures of emergency and outpatient services.
• Health System Agencies demonstrated a preference for system shrinkage, approving a majority of reported hospital closures.
• Future trends suggested a slight increase in openings and expansions compared to the analyzed period, with an anticipated decrease in closures.