Following is a commentary from the R.I. Business Group on Health regarding Care New England’s decisioon to close Pawtucket Memorial Hospital.
As a retired hospital CEO, and Executive Director of the RIBGH, I know that closing a hospital is always a painful action and it should be because these organizations have made important contributions to a local community. However, communities and their leaders need to understand that hospital closure is an ongoing trend in the United States. According to the American Hospital Association, in 1996, 6,021 hospitals served the people of the United States. By 2015, the number of hospitals in service declined to 5,564. The rate of closure in the Northeastern United States has been even greater because the population is not growing.
Hospital closures are due primarily to clinical advances that both keep patients out of hospitals and reduce the time spent in hospitals when admitted. The challenge for Rhode Island’s community, political, and labor leadership is to incorporate the lessons learned from hospital closures across the nation as they help lead the community through this challenging period.
Two lessons stand out. The first is hospital closures, on average, do not lead to loss of jobs. As previously noted, between 1996 and 2015, there was a 10.3% reduction in the number of hospitals in the United States. In 1996, US hospitals employed more than 4.3 million full time employees. In the same time period, despite hospital closures, the number of people employed by US hospital increased by 26%, from 4.3 million to 6 million employees. Similar trends occurred in Rhode Island in the late 80s/early 90s resulting in the closure of acute care hospital facilities at Fogarty Hospital, Notre Dame Hospital, Cranston General Hospital, and Saint Joseph’s Hospital. Since the mid-90s, the number of people employed by hospitals in Rhode Island has increased approximately 23%.
The second lesson is that hospital closures do not lead to detrimental patient outcomes, based on recent studies. According to a study of Medicare data by researchers from the Harvard Medical School, which was published in Health Affairs in 2015, not only was there no association between hospital closures and worsening outcomes in the involved communities, researchers felt that the over supply of healthcare services in a region, can lead to wasteful use of resources and increased costs that do not necessarily produce better outcomes.
Finally, community, political, and labor leaders should also remember that a 2013 study of hospital capacity commissioned by the Rhode Island Executive Offices of Health and Human Services, on behalf of the General Assembly, concluded that Rhode Island would have 200 too many hospital beds by 2017.
The RIBGH supports the Care New England decision to close Pawtucket Memorial Hospital. The challenge for Rhode Island’s political, community, and labor leadership is to support the changes necessary that strengthen the remaining hospitals so that they contribute to a higher quality, more affordable “system of hospitals” serving the residents and businesses of the State of Rhode Island.
Al Charbonneau is executve director of the Rhode Island Business Group on Health.