With Hospitals, It's Survival of the Fattest, Not the Fittest

From 1996 to 1998, researchers at Boston University School of Public Health updated an existing data set on U.S. urban hospital closings, mergers and other changes for the years 1936 through 1980 by extending the analysis through the mid-1990s.

This project was part of the Robert Wood Johnson Foundation (RWJF) national program Changes in Health Care Financing and Organization (HCFO).

Key Findings

  • More than 27 percent that were open in 1980 had closed by 1997, with a reduction of 66,000 beds.

  • For-profit hospitals, non-teaching hospitals, and hospitals in neighborhoods with higher minority populations were more likely to close.

  • Interestingly, more efficient hospitals were not more likely to remain open; rather, hospitals that were more financially sound and with greater financial resources were substantially more likely to remain open.

  • The pattern of hospital closures revealed by the data may affect access to care for urban minority populations, especially African Americans.