title: Impact of the closure of a large urban medical center: a quantitative assessment (part II).
abstract: This community health needs assessment-the second part of a mixed-methods project-sought to quantitatively determine the impact of the closure of St. Vincent's Medical Center, a large not-for-profit hospital in NYC on individuals who used its services. Findings from a community survey disseminated to the broader community affected by the closure of this hospital are described. The questions covered topics including demographics, health status, experiences accessing health care pre- and post-hospital closure, access to medical records, prescriptions, etc. The majority of respondents are from the community immediately surrounding the hospital. Almost 50% report having a physical or mental health condition requiring regular care; roughly 64% had a doctor affiliated with St. Vincent's and 68% currently see the same doctor as before the hospital closed. With regard to service utilization, 74% reported having sought services at St. Vincent's in the past 5 years. Of these, the emergency department was the most commonly used service (75%), followed by specialty tests (32%), inpatient care (30%), and outpatient services (22%). The majority of ratings of services at St. Vincent's were "excellent" or "very good." Conversely, 65% of former St. Vincent's users reported more difficulty obtaining health care post closure. Of the 11% who have tried to access their medical records, 30% have not been able to obtain their records and 42% report their attempt as being "somewhat difficult" or "very difficult." Over 50% report spending more time traveling or traveling further to get to their healthcare provider; and over one third report waiting longer to get an appointment, or to be seen when at an appointment. Bivariate analyses revealed that certain subgroups of respondents had significantly worse negative experiences associated with the closure of the hospital. Specifically, individuals with a health condition were more likely to have visited an ER since St. Vincent's closed, and now travel further and spend more time traveling to their health care provider, compared to those without a physical and/or mental health condition. Similarly, a greater proportion of respondents who had a doctor affiliated with St. Vincent's reported greater challenges accessing care since the closing, compared to those who did not have a doctor affiliated with St. Vincent's (e.g., waiting longer to get an appointment). Finally, the same health care challenges were being experienced by those who are not seeing the same doctor as prior to the closing.
authors.affiliation: CUNY School of Public Health at Hunter College, 2180 Third Avenue, Room 542, New York, NY 10035, USA. diana.romero@hunter.cuny.edu
authors.forename: Diana
authors.initials: D
authors.lastname: Romero
authors.forename: Amy
authors.initials: A
authors.lastname: Kwan
authors.forename: Sue
authors.initials: S
authors.lastname: Nestler
authors.forename: Neal
authors.initials: N
authors.lastname: Cohen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002410:Catholicism; D055812:Community-Based Participatory Research; D005260:Female; D006271:Health Facility Closure; D006297:Health Services Accessibility; D016519:Hospitals, Religious; D006786:Hospitals, Urban; D006788:Hospitals, Voluntary; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009519:New York City; D011795:Surveys and Questionnaires; D019037:Urban Health Services; D055815:Young Adult