HAP Blog

When is a hospital more than a hospital?

December 20, 2023

In the absence of a public health system, hospitals play a crucial role in Pennsylvania to keep their communities healthy in so many ways. This role reaches way beyond treating the sick and integrates into many aspects of public health as well as social and economic environments of their communities.

Out of 67, nine of Pennsylvania’s counties do not have a hospital. Below are a few ways hospitals take the lead into strengthening the populations they serve in the counties where they exist.

Overall health status is better in counties that have at least one hospital.

Counties with at least one hospital are healthier populations than counties without any hospital. Of all the main county health ranking measures listed below in Figure 1, counties without a hospital shows worse health outcome than counties with hospitals.

Figure 1. Health determinants of Pennsylvania counties based on hospital presence. 

Health determinants of Pennsylvania counties based on hospital presence

Source: CDC

They provide the providers!

The counties with a hospital have more than three times more doctors and practitioners per 100,000 population than the counties without a hospital.

Provider rates vs. hospital presence

Source: HRSA

According to the Health Resources and Services Administration (HRSA), Pennsylvania counties without any hospitals have a drastically higher number of primary care and mental health shortage areas than counties with a hospital on average.

Number of HPSAs vs hospital presence

Source: HRSA

Hospitals as economy drivers!

Hospitals are economic anchors of the communities they serve. During fiscal year (FY) 2022, Pennsylvania hospitals generated $182 billion in economic activity, supported more than 590,000 jobs and $37 billion in salaries. On top of that, they contributed to their communities by charity care, financial health care support, education, research, and many initiatives that add up to nearly $9 billion (HAP). In 21 counties, a hospital is the largest employer, and in 58 counties they are one of the top 10 employers (PA DL&I).

As seen in the figures below, the average unemployment rate in counties without a hospital is 6 percent, while counties with at least one hospital have an average of 5.2 percent unemployment rate.  

Unemployment rate

Source: US Census Bureau

Families in Pennsylvania counties with at least one hospital earn $3,000 more on average per capita income and $8,000 more on average median household income than the families who live in counties without a hospital.

Income

Source: US Census Bureau

Despite these facts, many Pennsylvania hospitals face financial strain. According to the Pennsylvania Health Care Cost Containment Council, 39 percent of Pennsylvania’s general acute care hospitals posted a negative operating margin for FY 2022 and another 13 percent had an operating margin of less than 4 percent.

Nationwide, hundreds of hospitals are on the verge of closing, especially in rural areas. In Pennsylvania, currently 11 rural hospitals are at risk of closing (CHPQR). Imagine what would happen to their communities if their financial situation is not improved, and let’s think about how we can prevent these closures.

 


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