Loss of hospital beds hurts all

TWO VIEWS •ÊWith Woodland Park, Eastmoreland facilities shut, Portlanders face a changed landscape in health and medical services

The recent closures of Eastmoreland and Woodland Park hospitals have created a considerable amount of concern. That is understandable. Eastmoreland has served Portland for 60 years, Woodland Park more than 40 years. It's always difficult to see institutions with long histories in our city close their doors.

Much of the concern has been about whether there is sufficient capacity in other Portland hospitals to replace the beds and services lost in the closures. With the exception of inpatient psychiatric beds, of which Portland has far too few, most of the patient needs of the two hospitals will be met by other hospitals in the Portland area.

Granted, even if the capacity does exist to absorb the demand for inpatient and outpatient services that Eastmoreland and Woodland Park once filled, people served by the two hospitals will miss the convenience of having those services nearby.

Local businesses also will feel the impact of losing the customer traffic they gained from employees, patients and visitors at the hospitals.

Sadly, Eastmoreland and Woodland Park had been struggling for years under several owners. But it was a combination of factors Ñ an increase in Medicaid patients, a decrease in Medicaid payments, a decline in private-pay patients and low admission rates compared to other Portland area hospitals Ñ that finally forced the doors to close.

The rate of Eastmoreland's Medicaid admissions rose from 5.8 percent in 2002 to 10.6 percent in 2003; during the same time period, private-insurance admissions fell from 31 percent to 23.5 percent.

The situation was similar at Woodland Park Hospital: Medicaid admissions rose from 5.5 percent in 2002 to 22.6 percent, and patients with private insurance fell from 52 percent to 40.6 percent.

Compared with other Portland hospitals, overall utilization at the two facilities was more bad news.

Citywide in the last 12 months, total hospital admissions fell 0.7 percent; at Eastmoreland and Woodland Park hospitals, admissions declined 28 percent and 19.4 percent respectively.

Perhaps the largest reflection of the financial crises at the two facilities was the increase in bad debts.

Eastmoreland Hospital incurred a 22.7 percent increase in bad debts, from $1.1 million in 2002 to $1.4 million in 2003. Woodland Park saw a 22.5 percent increase over the same 12 months, from $2.9 million to $3.6 million.

At a time of high unemployment and with new cuts to the state Medicaid program just around the corner, the most significant impact of the hospital closures is the loss of hundreds of jobs at an average annual salary of more than $51,000.

Even with the cutbacks the two hospitals had made over the past several years, they still contributed a $19 million payroll to the city of Portland.

They also provided health insurance to employees and their families, and this coverage is now also lost.

Hospitals in the tri-county Portland area employ more than 18,000 people at an average annual salary similar to that paid to Woodland Park and Eastmoreland employees. They generate a combined annual payroll of almost $1 billion.

The health insurance the hospitals offer to employees and their families provides health coverage to more than 30,000 people.

The city of Portland is right to be concerned about health care access when hospitals close. Perhaps the message we also need to understand is that when hospitals close, there is probably an even bigger economic impact.