The closure of surgical hospitals disproportionately hit poor and socially vulnerable communities

A new national study reveals that surgical hospitals have been closed with a significantly higher percentage than new ones, with disproportionately concentrated communities with high levels of poverty and social vulnerability. The study highlights an increasing difference in access to surgical care.

The research will be presented at the Clinical Conference of the American College of Surgeons (ACS) in Chicago, October 4-7.

The researchers used data from the American Hospital Union to monitor hospitals performing at least 100 businesses per year in 2010 and 2020. Between hospital opening and closing, they found a net reduction of 298 nationwide surgical hospitals. The authors of the study then used the Disease Control Centers and the Prevention Centers for Social Vulnerability (SVI) to compare the socio -economic characteristics of the areas by closing hospitals against those with fixed or new hospitals.

We were surprised by how big a number was. It is quite amazing to see such a drastic decline without adequate replacement volume and concerns patients’ access to care. ”

Jesse E. Passman, MD, MPH, MSHP, Head writer, general surgery at the University of Pennsylvania Hospital, Philadelphia, Pennsylvania

Basic findings

“One of the hidden things lost in The Shuffle is patient records,” said senior writer Heather Wachtel, MD, MTR, FACS, Associate Professor of Surgery at the University of Pennsylvania. “When a hospital closes, patients who have taken care of them may lose access to their healthcare files. Having this information they are necessary for their continued health care.”

The reasons for the closure, although not studied immediately, are likely to be financially related to the challenges in maintaining smaller hospitals and security institutions that serve a high percentage of government insurance patients, the authors note.

Impacts for patients and health systems

The study highlights several critical consequences of hospital closure:

• Loss of medical history: Patients may permanently lose access to their medical records, leading to expensive and dangerous double tests, medical history restoration and lack of critical health information about new providers.

• Patients can give up care: Increased travel weight and finding new providers can cause some patients to delay or completely avoid the search for the necessary medical or surgical care, allowing the deterioration of conditions.

“For each of these patients who really appear in our hospitals, I am sure there are many patients who do not,” Dr. Passman said. “These conditions that could be addressed and possibly treated surgically are now attracting and having chronic problems.”

The co-authors are Jeffrey L. Roberson, MD, MBA. Sara P. Ginzberg, MD, MSHP. Jasmine Hwang, MD, Ms. Gracia M. Vargas, MD. Rachel R. Kelz, MD, MSCE, MBA, FACS. Giorgos C. Karakousis, MD, FACS. and Vicky W. Tam, but.