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Can closing a hospital improve the quality of care?

The closing of St. Vincent’s Hospital in the Village in New York City at first glance would reduce access to care for New York residents living in the area.  To fill the void, however, a number of non-traditional providers have entered to fill the space.  For instance, the number of stand-alone urgent care centers are expanding (“Urgent care centers are opening at the pace of Starbucks”) as are the number of physicians who practice in pharmacies.

Consider the symbiotic relationships that are developing between pharmacy-based physicians and hospitals:

Continuum [Health Partners] has also become affiliated with doctors practicing out of 13 Duane Reade drugstores in Manhattan and Brooklyn, and has a contract to expand to 20 within the next year or so, and to 50 within four years, said Dr. James A. D’Orta, chairman and chief executive of Consumer Health Services, which manages the practices in the pharmacies.

No money changes hands in the Duane Reade affiliations, Mr. Henick said, but there are indirect benefits for both sides. The hospital system checks doctors’ credentials and provides — and bills for — laboratory, radiology and imaging services prescribed by the Duane Reade doctors. The system also gets a potential trove of patients referred by the clinics. The Duane Reade clinics earn the cachet of being associated with major hospitals, and as with other affiliated practices, the Duane Reade patients are given expedited access to Continuum specialists and direct access to hospital admission if needed.

Quality

Has quality of care suffered? Although results are preliminary, the answer appears to be ‘no’.  In fact, quality of care seems to have improved.

“I was seen immediately,” Ms. McKenzie said. “It wasn’t crazy chaotic like St. Vincent’s was. I only had to tell my story once, and I was treated by the same physician I told my story to.”

Dr. Charles Carpati, former chief of intensive care at St. Vincent’s, now at Lenox Hill Hospital, said the community seemed to be coping without the old hospital.

“It’s been very hard to show that people are dying because St. Vincent’s is no longer there,” Dr. Carpati said.

2 Comments

  1. Interesting post, it makes sense that bringing more specialization into the treatment of people is a good thing.

  2. I agree with the fact that quality of care seems to have improved. The Health services should be quick enough to respond at the time of emergency, while the symbiotic relationships between pharmacy-based physicians and hospitals, can create a major loss to the suffering person.

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