How Chicago journalist used data to show how population and insurance shifts affect hospital vacancy
By Kristen Schorsch
The traditional sense of a hospital is fading.
Advances in technology, changes in how doctors and hospitals are paid, and a big push toward outpatient care mean patients aren’t spending as much time in hospital beds as they used to. In Chicago in particular, huge population shifts have gutted many minority communities anchored by hospitals.
The result? A lot of empty beds. I found quite the increase in vacancy rates while analyzing state records and interviewing dozens of people for my project, Running on Empty, which included this database that readers could search for information on every hospital in Illinois.
In Illinois, more than 12,000 of the roughly 33,000 beds staffed by doctors, nurses and other providers in 2013 were empty even when these facilities were at their busiest. That's nearly 4 of every 10 beds lying vacant.
The emptiest facilities were tiny hospitals in the rural central and southern parts of the state. A subsidy from Medicare, the federal health care program for the elderly, helps these facilities stay open.
In the Chicago area, older urban hospitals had the most vacant beds, while newer suburban facilities and teaching hospitals were fuller. Still, there were exceptions. Even the newest hospital in the state in 25 years was half-empty.
For reporters looking to dig into how full or empty hospitals are in their communities, here are five questions to consider:
Photo by Mark Hillary via Flickr.
Where’s the data? Check with sources who might have access to the most up-to-date information. Don’t forget to check with your local public health department and state regulators who decide the fate of health care projects. In Illinois, hospitals have to publicly report a vast amount of information.
What led to this? Once you identify trends, interview hospital CEOs, the consultants who advise them, patients and advocacy groups that look out for them. For my project, I also talked with demographers to better understand how population shifts have affected hospitals and their customers over the years.
What are the implications? If hospitals have many empty beds, what is their strategy for survival? Some hospitals might merge with those with more resources, while others might affiliate in order to share services while preserving their independence. Some hospitals might convert into another type of facility, such as outpatient clinics. And others might just close.
What are the obstacles to change? Closing or converting isn’t easy. It can be very expensive and create access issues for patients. Plus, everyone from residents and politicians to hospital boards and physicians can resist change. Hospitals are often the biggest employers in their communities, and closing or converting can reduce access to care for the poor and elderly in particular.
Go bigger. How do the trends in your community compare to those happening nationwide? Are there lessons to be learned from other places around the country that went through the same dramatic changes?
Kristen Schorsch is a health care reporter at Crain's Chicago Business, where she follows the money within the hospital, health insurance and pharmaceutical industries and has covered their dramatic transformations under the Affordable Care Act. She can be reached at email@example.com or @kschorsch.