Hurricane Katrina. The disaster after the disaster

More than a decade after Hurricane Andrew devastated much of South Florida and a year after a series of killer storms battered the state, hospitals there offer stark lessons--as well as inspiration and hope--for their counterparts reeling from Hurricane Katrina.     

Hospital and community characteristics in closures of urban hospitals, 1980-87.

Characteristics of 190 urban community hospitals that were closed during the period 1980-87 and characteristics of the communities that they served were analyzed and compared to a control group of 380 urban hospitals that remained open. A negative association was found between hospital closure and four hospital characteristics: the presence of a cancer program approved by the American College of Surgeons, the combined characteristics of for-profit status and membership in a multi-institutional chain, the number of admissions, and the number of facilities and services offered. A positive association was found between hospital closure and the percentage of black residents in the community. These findings are discussed in the context of political and economic trends in health care and urban development. Implications for future research are noted, including managerial strategy for hospital administrators and the socioeconomic implications of hospital survival in declining urban communities.     

The changing face of rural Catholic hospitals

Socioeconomic trends and developments within the U.S. healthcare system have challenged rural hospitals' ability to maintain adequate operating margins and offer needed services. However, some hospitals have fared better in this negative environment than have others. To clarify factors that distinguish the most viable rural Catholic hospitals from the least viable, our study identified a group of 30 "consistently sound" hospitals and 30 "adversely affected" hospitals based on profit margins and six other financial measures. As a group, rural hospitals suffered from declining inpatient utilization, increasing levels of indigency, and adverse reimbursement. However, the consistently sound hospitals' margins increased to 11 percent form 1985 to 1989, whereas margins at adversely affected hospitals fell nearly 8 percentage points during the same period. Adversely affected hospitals were less likely to belong to a system and had significantly fewer average staffed beds than did the consistently sound facilities. Their communities had significantly lower per capita income, and they devoted a greater percentage of their resources to care for the poor. Adversely affected hospitals also reduced the scope of available services more drastically than did consistently sound hospitals during the period under study.     

Rebuilding New Orleans after Katrina, part 2

Hurricane Katrina occurred on August 29, 2005, followed by Hurricane Rita on September 24, with destruction extending along the Gulf Coast to Beaumont, Texas. Reentry into New Orleans began in mid to late September last year and occurred in stages, with the least devastated areas being gradually reopened first. People began trickling back in until the city was finally fully opened in December except for the Ninth Ward and East New Orleans.