Rutgers Center for State Health Policy Finds New Jerseyans Worried by Hospital Closures, Emergency Response Capability

• Read editorial in February 21 Star-Ledger: Patients are right to worry
  

NEW BRUNSWICK, N.J. – The declining fiscal health of many New Jersey hospitals – underscored by the closure of nearly 20 facilities during the past 10 years – has not gone unnoticed by state residents. A study by the Center for State Health Policy (CSHP) at Rutgers, The State University of New Jersey, funded by the Robert Wood Johnson Foundation, finds that 50 percent of Garden Staters are at least “somewhat worried” by the closures, and 78 percent feel the same about the remaining hospitals’ ability to respond effectively during mass casualty emergencies.

“The closures and the fact that several others are either in bankruptcy or filing for closure, raise concern about the ability of the state’s hospitals to meet the needs of residents in emergencies such as major disease outbreaks, natural disasters or terrorists attacks,” said CSHP Assistant Professor Derek DeLia, lead author of the “New Jersey Health Care Opinion Poll: Public Concern about Hospital Capacity.” He observed that concern about hospital closures is strongest in the northeastern part of the state, where 10 closures have occurred since 1997. Concern about closures is also very strong among black, Hispanic and inner-city residents and among individuals who are less healthy, uninsured, have trouble affording health care and have low income.

DeLia added that concern over emergency response does not vary much by region, but rather residents of inner cities are more likely to worry, and disproportionate concern is found among blacks, Hispanics and those with trouble affording health care.

“Vulnerable and minority populations have disproportionate concern about closures and disaster response likely because they rely on hospitals for a wide range of medical care services,” DeLia said. “Also, these populations could easily be left behind during a disaster if special considerations are not made in disaster planning activities.”

Since 1997, 10 hospitals in northeast New Jersey (Bergen, Essex, Hudson and Passaic counties) have closed, but no closures have occurred in the northwest (Morris, Sussex and Warren) and central west (Hunterdon, Mercer and Somerset) counties. Five facilities have shut their doors in the central east counties of Middlesex, Monmouth, Ocean and Union, and four have closed in the south, comprising Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester and Salem counties.

Based on the survey of 1,104 adults in June and July 2007, 32 percent of adults in New Jersey were “very worried” about hospital closures overall and 42 percent were “very worried” in the northeast, which is dotted with many older, urban areas. In contrast, only 21 percent of those surveyed in northwest counties felt the same.

New Jerseyans’ unease about hospitals’ disaster response capabilities parallels their anxiety about closures: 35 percent of residents from both the northwest and central west regions, which have had no closures, were “very worried” about hospitals’ potential ability to respond. In the three remaining regions, the average percentage who were “very worried” was more than 10 points higher; northeast residents showed the most anxiety at 49 percent “very worried.” Overall, 44 percent of respondents were “very worried” about hospital preparedness.

Prior studies by the CSHP found that hospital capacity throughout the state often falls below federal disaster planning benchmarks. However, public concern about hospitals’ disaster response capabilities is not concentrated in regions most likely to fall below the benchmarks. For example, in the northwest, concern about response capabilities is comparatively low even though the region is most likely to fall below the planning benchmark. 

Age, among various socioeconomic variables studied, appeared to have little effect upon residents’ attitude toward hospitals shutting down, DeLia said. “Less healthy individuals, those with less income and the uninsured tend to worry about hospital closures,” he said. “Worry is generally not related to age, except for adults ages 50 to 64 who show somewhat less concern than other adults.

“Also, persons from households with a health care worker worry neither more nor less about possible shutdowns than other individuals.”

Rutgers’ Center for State Health Policy informs, supports and stimulates sound and creative state health policy in New Jersey and around the nation. The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing the country.

Complete poll findings are available.