Hospital expansion, lots of it

Have you noticed the number of hospital expansion projects in your area? Odds are quite good that you have. If not, read here, here, here, here, here, and here. That’s a small sample.

I realize that some hospitals have finally reached a strong enough financial position and can now expand after putting off the need for years. And that our population is aging: to prepare we need more capacity.

What if the expansion is due to a medical arms race? A Health Affairs article says, “Hospitals are increasing capacity in high-end and high-volume product lines, to compete with other hospitals and freestanding outpatient facilities.”

That makes sense financially, but is not necessarily good for the patient.

What are we going to do with all the capacity when the retirees are no longer so numerous? Another Health Affairs article says, “Ultimately, a great deal of added cost to the health care system will result from recent construction activity, some of which might be attributable to costly duplicative and underused capacity.”

And this should be sobering. This article in the Journal of the American Medical Association says that when a cardiac hospital opens, heart surgery in the Medicare population within that community increases. In other words, capacity creates demand. If things stay the same (doubtful, I know…but for the argument’s sake) we won’t need to worry about excess capacity because those beds will be filled…potentially with patients who really don’t need to be there.

I’m all for hospitals growing with a purpose, it just scares me of the managerial (and cost!) problems these expansion projects could leave us with in 30 years.

Some good reading related to hospital expansion.

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