Perception of Administrators at Independent Hospital Regarding Stabilty

Perception of Administrators at Independent Hospital Regarding Stabilty

Chapter Two: Literature Review

Introduction

The perception of administrators at small independent hospitals regarding financial stability has led to closure of so many of those institutions. Since the practice has become so rampant, the negative effects have become significant to many communities because they rely heavily on these small independent hospitals. The chapter presents a review of literature that focuses on identifying any literature gap, which the study will attempt to fill by using related data from the previous studies carried out by the different scholars in order to have a better insight of the problem. The literature review is aimed at highlighting in detail the problem of closure of the small and independent hospitals whose prevalence over the last decade has seen a marked increase of the closure of these hospitals and it has become alarming because of the adverse consequences from the beneficiaries in rural areas. In the process of the discussion, the research will explore a spectrum of issues surrounding the problem of this research study.

Theoretical Framework

The perception of administration at small independent hospitals regarding financial stability of these facilities that play a significant role in the provision of primary and secondary healthcare is focus of this study. This has been necessitated by the massive closure of hospitals in many States across the United States of America. Prevalence of this has been witnessed in California State, which has motivated the research to be undertaken in this area.

Historical Overview

Healthcare is one of the most critical basic services required to sustain the medical needs of any nation. The United States of America as a nation has over the centuries made efforts to have its citizens have access to sufficient and quality healthcare. The U.S. Census Bureau (2009) indicated that about seventy two million Americans who reside within the rural areas, which means this population relies heavily on small and independent hospitals within their vicinity for access of healthcare services. In an attempt to meet this gap, small independent hospitals have been, and continue to be set up in all the States in order to provide healthcare facilities to the citizens. Since the biggest proportion of the population in the United States resides in rural areas or places distant from urban settings, access to health services becomes quite difficult.

The large gap in the provision of healthcare gave individuals, investors, and private medical practitioners the opportunity to set up small hospitals in an effort to bring healthcare services closer to the people while at the same time taking this chance to make profits. It is also important to note that not all the small independent hospitals set up were for-profit, but they were community hospitals that were charitable enough to provide healthcare at no cost. Consequently, small independent and rural hospitals were established and they facilitated the delivery of vital healthcare services. As a result, the rural people no longer needed to travel for long distances in order to get healthcare. On the other hand, the small independent hospitals are expected to improve access to quality and emergency care, involve the people in development of appropriate health care systems, and establish a system of coordination between small independent hospitals and large hospitals where transfers and referrals can be made in situations when the small hospitals do not have sufficient facilities.

Contextual Challenges

While the role and impact of small independent hospitals is so significant, it is important to acknowledge that these hospitals face massive challenges that make it quite difficult to sufficiently provide healthcare to the communities where they are located. Brimmer (2012) asserts that small or rural independent hospitals find it difficult to employ quality primary healthcare physicians because most of them prefer to work in bigger medical facilities. Furthermore, the same physicians find it quite challenging to move their families to reside in smaller towns that might not have required services like better schools for their children. This is a critical aspect because physicians choose to work in locations where they feel their families will be comfortable and also have an opportunity to grow in their careers. Incidentally, small independent hospitals cannot guarantee such expectations. In the long run, small independent hospitals fail to attract the high-caliber and highly experienced physicians, who patients in these community hospitals fail to get access to the best care and end up being referred to larger public medical facilities that are located in the urban centers. The net result is that these small and independent hospitals will have very few patients to treat.

General Findings

The closure of small and independent hospitals has been growing over the past several years, a rate that has been alarming and there are many reasons accounting for these turn of events. According to O’Donnel and Ungar (n.d.), there is a consistent pattern of the closure of hospitals in Georgia since 2010 where 43 hospitals had closed, which by 2013 had accounted for the loss of about 1,500 beds. The same hospitals were serving a total population of 10,000 citizens as such a closure on a massive scale is not only worrying, but giving the residents a challenge in accessing the required healthcare facilities.

McSherry (2012) documents financial challenges associated with three independent hospitals (Victor Valley Community Hospital, Colorado River Medical Center, and Hi-Desert Medical Center) that are located in the desert areas, which are far away from urban centers and were critical in providing health care to the vast populations. Just like all other small or rural hospitals, the financial challenges that affected these institutions include problems related to reimbursement, the need to implement healthcare reform, and implementation of electronic records. Consequently, these institutions were declared bankrupt and they have been struggling to find investors to buy the institutions or to convert the institutions into not-for-profit institutions. The report concludes that small independent hospitals have very limited financial resources and they most of the time do not have a fall-back position when there is no longer money to support the establishment. As a result of this, the hospitals are forced into closure.

The core factor that precipitates the massive closure of small independent hospitals has everything