Neighborhood characteristics and hospital closures. A comparison of the public private and voluntary hospital systems.

This paper analyzes the neighborhood distribution of hospital closures in New York City between 1970 and 1981. Discriminant analysis procedures are used to compare the social, economic and health status characteristics of neighborhoods in which hospitals have closed with those of neighborhoods in which facilities have remained open. The results show that overall hospital closures have had a substantial distributional impact, with facilities in low-income, high infant mortality neighborhoods having the highest rates of failure. Closures of voluntary hospitals occurred most frequently in disadvantaged neighborhoods; whereas municipal and proprietary hospital closures showed no differential neighborhood impact. Implications for the geographical accessibility to various groups to health care and for the efficiency and cost of hospital services are discussed.