Document Information
The Public Hospital System in Louisiana
Key Findings:
- The key consideration following closure of a public hospital is to ensure that the level of uncompensated care provided in the community (the safety net) is maintained. Some communities that closed their public hospitals developed local coverage programs to purchase care for the indigent uninsured; these arrangements facilitated continuing care and were associated with expanded ambulatory care and fewer preventable hospitalizations.
- A critical issue for most communities deciding to close a public hospital involved the ownership of facilities that would care for the indigent uninsured; the principle concern was how a change in ownership would affect the facility’s mission as a “provider of last resort.”
- All ownership models studied appear to have maintained existing levels of uncompensated services following closure of a public hospital when contracts and regulations were designed to address this issue.
- Medical education in the community appears to be maintained following closure of public teaching hospitals.
- Achieving the community goal of providing high-quality care to all citizens depends on careful needs assessment, planning, and consensus building. Planning includes determining the mission of any new facilities, carefully assessing local supply of and demand for health care, understanding local market forces, and determining an appropriate governance, financing and regulatory structure.
Free, downloadable PDF file(s) are available below.
RAND makes an electronic version of this document available for free as a public service.
Use Adobe Acrobat Reader version 7.0 or higher for the best experience.
The research described in this report was performed under the auspices of RAND Health.
This product is part of the RAND working paper series. RAND working papers are intended to share researchers' latest findings, to solicit informal peer review, or to publish a technical appendix to an article published in a scientific journal. They have been approved for circulation by the sponsoring RAND research unit but typically have not been formally edited or peer reviewed. Unless otherwise indicated, working papers can be quoted and cited without permission of the author, provided the source is clearly referred to as a working paper.
Permission is given to duplicate this electronic document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND PDFs to a non-RAND Web site is prohibited. RAND PDFs are protected under copyright law. For information on reprint and linking permissions, please visit the RAND Permissions page.
The RAND Corporation is a nonprofit research organization providing objective analysis and effective solutions that address the challenges facing the public and private sectors around the world. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.
* RAND research is conducted across divisions, centers, and projects; these organizational components are represented in the "Related RAND Divisions" section above.
Top
RAND® is a registered trademark. Copyright © 1994-2008 RAND Corporation. 