Hospital Downsization Case Study

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Hospital Downsizing

The modernization of hospitals and hospital services can be traced back to 1840 when facilities began to change their focus from caring for the impoverished and mentally ill, to becoming a place known for providing complete health care to the population. After the Second World War, the government identified a deficiency in the health care system and the response to was passage of the Hill-Burton Free and Reduced Cost Health Care Act in 1946.
The Hill-Burton Act provided government subsidies to aid in the construction and modernization of local government hospitals as well as not-for-profit facilities. Hill-Burton established a goal ratio of 4.5 beds for every 1000 people; the greatest period of hospital growth due to this legislation was from 1947 to 1971 when an estimated $33 billion
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With improvements in home health care and other services available to provide subacute continuity of care outside of the hospital setting, early discharge became one of the means by which hospitals have been able to reduce the overall length-of-stay to remain profitable (Shi & Singh, 2015).
Because of the improvements in delivery of health care, the beds to patient ratio established by the Hill-Burton Act has been below the established goal since 1998. The decline in the number of available beds may be attributed to the closures, mergers, and acquisition that have affected over 700 facilities since the 1980’s (Shi & Singh, 2015). However, this is balanced by the increasing efficiency in utilization of available resources, due in part to the advances in medical technology and improvements in the types of services available to patients on an outpatient basis.
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