Competing Narratives of Hospital Closure: A Case Study of Memorial Hospital of Rhode Island.

ABSTRACT

BACKGROUND: Hospital closures have become commonplace in the United States but remain controversial. Memorial Hospital of Rhode Island was a 294-bed hospital in a disadvantaged community that closed in 2018 amid falling patient volume and rising costs. METHODS: Immersion/crystallization method of qualitative analysis was employed in reviewing semi-structured interviews, public testimony, and public documents. Themes that emerged were organized into discrete narrative typographies, represented by illustrative quotations. RESULTS: Three main narratives of the hospital's closure arose 1.) financial inevitability; 2.) corporate mismanagement; and 3.) systems realignment. CONCLUSIONS: Overlapping and discrepant narratives of the closure demonstrated the complicated role of hospitals within communities and health systems. Acknowledgment of both the hospital's financial straits and the negative impacts of closure on a marginalized community demonstrate the malalignment of economic incentives and the public good in the state's health care system. This case study may offer lessons for other communities facing or experiencing hospital closure.