In May, 2003, St Agnes Hospital, a small facility in White Plains, New York, failed financially, and was taken over by Westchester Medical Center in Valhalla (Zhao, 2003).
The 184 bed hospital, founded by a Roman Catholic order a century ago, had been plagued by the inability to raise sufficient funding, and ended up with a total debt of 90 million dollars (Zhao, 2003). St Agnes was an institution dedicated to the poorer population, and unable to compete with the large inner city hospitals, was unable to benefit from the community financially.By September, 2003, Westchester Medical had abandoned the project, stating that St. Agnes had more debt that believed initially, and Westchester had “made a hasty and uninformed move to save them” (Zhao, 2003). Several days after the decision, Westchester began the steps to close the doors of the hospital, and St Agnes was forced to leave a poor community with few resources more vulnerability (Zhao, 2003).Without protection from governmental agencies regulating the policies of hospital assistance, and grass roots partnerships, hospitals and other healthcare facilities will continue to close, and more people will be denied access to medical care (Halvorson, &. Isham, 2003).
Policies in place are essential to assure hospitals like St. Agnes, are compensated by state or federal agencies to reimbursement for the substantial unreimbursed care they provide (Walsh, 2006).Studies have indicated that, “30 percent of patients whose hospital closes stop seeking care” (Sheperd, 2002). When removing a healthcare facility from a community, the most vulnerable patients, are made more vulnerable. Elderly without transportation, begin a cycle of self neglect, as access to healthcare dwindles.
Inevitably, (Sheperd, D.S., 2001) surrounding hospitals are expected to absorb the same costs that closed the doors of the other, and eventually will suffer the same problems of debt (Walsh, 2006).Hospitals provide jobs for local people as well, and are marketing resources for vending and supply business, and necessary for networking (Kronenfeld, 2002).
Unemployment rises in a community when a hospital closes, and transportation to other areas may not be an option for the unemployed worker.Community resources, such as Out Reach Projects, provide staff for education and assistance to the public by assessing their needs from hospital databases. (Sheperd, 2002). Many hospitals have health fairs, teaching fairs, and health screening activities for the population. Medical centers provide important tools that are used to increase wellness, and detect early disease (Walsh, 2006).Many hospitals provide much of the primary care available in an area through their outpatient services such as diagnostic tests and clinic visits.
Patients seek care only when they’ve become gravely ill, and healthcare costs go up exponentially to treat them. Especially in neighborhoods with high poverty rates and large numbers of uninsured and underinsured individuals, the lack of access to primary care is a significant factor in creating health care disparities (Sheperd, 2002).It is paramount for New York to adopt a hospital recovery plan that measures the impact of a closed hospital against the debt it has acquired. Shepherd (2002), states that “at least a legal requirement for local EMS agencies to prepare a written report evaluating the potential community impact of downgrading or closing emergency room services (p.39).The problems are that emergency room care is very expensive, and the uninsured use the services for regular healthcare (Shepherd, 2002). Hospitals can no longer absorb the costs of unreimbursed care.
A public policy is needed to address the public healthcare issues that removing resources impacts on a community.