Some rural hospitals to choose between merging services and closure, professor warns

December 19, 2012
Some rural hospitals to choose between merging services and closure, professor says

(Medical Xpress)—For the 32nd consecutive year, The University of Alabama's Office of Media Relations offers predictions from faculty experts for the coming year.

In 2013 and beyond, in Alabama will need to combine and coordinate their services – or some will close, a University of Alabama expert in rural and says.

"We have several rural hospitals that are hanging on by a thread because they are trying to maintain the old, autonomous model of hospital, provide full service and be on their own," says Dr. Richard H. Streiffer, dean of UA's College of Community Health Sciences.

"Rural hospitals need to change to a – to provide the first level of local that people need, and then coordinate effectively with a larger regional health system, such as one that DCH (Health System in west Alabama) would be well situated to develop, to support the next level of services and avoid duplicate services.

"If communities were to get together and coordinate with a regional center, we could have a much more efficient, effective and rational approach to providing health care in rural areas."

Having rural hospitals focus more on primary care and appropriate first-level care is one part of an even broader trend Streiffer predicts for health care across the state and the nation.

Through technology, doctors, in coordination with a team of health-care providers, will be able to provide patients with more services in the office and at home – meaning you may even see doctors restart making – which will decrease the need for hospital stays.

"Within three to five years, we will be doing care in people's homes and in outpatient settings that we only can dream of doing today," Streiffer says.

"Hospitals will become only intensive care units, operating rooms and procedure rooms. People won't be hospitalized for much other than those types of major services. With and , we can monitor and treat people in their homes, keep track of their blood pressure or blood chemistries, visually observe them, and deliver services to them while keeping them from getting institutional-borne infections.

"That will be a huge direction," Streiffer says. "While technology will never replace the personal physician who knows you, it will allow physicians to be much more effective, especially in remote or less populated areas."

Refocusing care from hospitals to homes will mean big changes in the ways institutions, like UA's College of Community Health Sciences, the Tuscaloosa branch of The University of Alabama School of Medicine, train physicians.

"Medical education will have to respond to this ecology of medical care," Streiffer says. "We still disproportionately train people in hospitals, which will become a smaller part of the health-care delivery system."

Streiffer also predicts that Gov. Robert Bentley eventually will accept federal help to expand eligibility for Medicaid in Alabama under the Affordable Care Act.

Increased access to primary care health care through Medicaid coverage will allow currently uninsured patients to have their own physician rather than just seek care when ill in emergency rooms, which are far more expensive and often less effective for advanced disease process while taxing the resources of hospitals, he says.

The Federal Medicaid match will provide an additional $6 billion in federal funds for a state investment of about $100 million, according to recent published reports.

With Medicaid funding to hospitals for care of the uninsured set to decline, hospitals will receive less compensation, yet, will still be obligated to treat uncovered patients who present for care. This will threaten their economic viability, Streiffer says.

"My hope is that Gov. Bentley will find a way to take the Medicaid funds, realizing it's for the benefit of the people of Alabama," Streiffer says. "That will drive the needed expansion of coverage of people and improve primary-care service. The funding will help 350,000 Alabamians who would get coverage because of expanded coverage."

Explore further: Health reform: How community health centers could offer better access to subspecialty care

Related Stories

Health reform: How community health centers could offer better access to subspecialty care

August 30, 2012
The Affordable Care Act will fund more community health centers, making primary care more accessible to the underserved. But this may not necessarily lead to better access to subspecialty care.

Will minorities be left out of health care law provision?

April 26, 2011
Hospitals and physician practices that form care-coordinating networks called "Accountable Care Organizations (ACOs)," under provisions of the new health-care law could reap cost-savings and other benefits. However, experts ...

US health care could shrink for illegal immigrants (Update)

December 14, 2012
(AP)—President Barack Obama's landmark health care overhaul threatens to roll back some services for the country's estimated 11 million illegal immigrants if clinics and hospitals are overwhelmed with newly insured patients ...

'Health care deserts' more common in black neighborhoods

April 25, 2012
New research into "health care deserts" finds that primary-care physicians are especially hard to find in predominantly Black and/or low-income Hispanic metropolitan neighborhoods.

Richest and poorest people in Toronto hospitalized for different reasons

June 4, 2012
Researchers who examined the income levels of patients at central Toronto hospitals found that people in the highest and lowest income brackets are being hospitalized for different reasons and that different hospitals serve ...

Recommended for you

Brain disease seen in most football players in large report

July 25, 2017
Research on 202 former football players found evidence of a brain disease linked to repeated head blows in nearly all of them, from athletes in the National Football League, college and even high school.

Safety of medical devices not often evaluated by sex, age, or race

July 25, 2017
Researchers at Yale and the University of California-San Francisco have found that few medical devices are analyzed to consider the influence of their users' sex, age, or race on safety and effectiveness.

Why you should consider more than looks when choosing a fitness tracker

July 25, 2017
A UNSW study of five popular physical activity monitors, including Fitbit and Jawbone models, has found their accuracy differs with the speed of activity, and where they are worn.

Dog walking could be key to ensuring activity in later life

July 24, 2017
A new study has shown that regularly walking a dog boosts levels of physical activity in older people, especially during the winter.

Alcohol to claim 63,000 lives over next five years, experts warn

July 24, 2017
Alcohol consumption will cause 63,000 deaths in England over the next five years – the equivalent of 35 deaths a day – according to a new report from the University of Sheffield Alcohol Research Group.

Alcohol boosts recall of earlier learning

July 24, 2017
Drinking alcohol improves memory for information learned before the drinking episode began, new research suggests.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.