Mayo Clinic Health Systems will close the Springfield hospital in March. While Allina Health will take over the clinic at some point in the spring of 2020, the hospital itself will remain shuttered.

Mayo’s Dec. 3 announcement of the closure rationalized the decision well. The Springfield hospital to that point had just nine inpatient admissions in 2019.

The hospital’s emergency department averaged fewer than four patients a day, many of whom could have been handled in a less expensive setting. With so few patients, Mayo said, retaining accreditation would be an issue. Presumably Allina shares Mayo’s evaluation that the Springfield market simply cannot support a hospital.

At least not a hospital as health care exists in 2019. Hospitals are expensive pieces of infrastructure, and the entities that pay for health care increasingly seek to avoid them.

Newborns and their mothers are discharged with a rapidity that would have been shocking in 1969. Outpatient surgical centers proliferate. Any business needs customer volume, and the Springfield hospital simply doesn’t have that.

But Springfield’s story is but one piece of the overall decline in rural health care, not only in Minnesota but elsewhere. Mayo earlier this year ended obstetrics and some other hospital services in Albert Lea; critics of that decision questioned Mayo’s commitment to rural health care. (MercyOne North Iowa plans to open some of those services in Albert Lea next summer.)

Dozens of rural hospitals have closed nationally this decade, mostly in the South, and as many as 430 more are said to be at risk of closing. We know, through scholarly studies, that mortality rates rise when a rural hospital closes and that childbirth complications rise when obstetric services are not locally available. Lose your hospital, and the quality of life declines.

And so we see the vicious circle at work. As rural America’s population declines, so does the quality of its health care — which helps prompt people to reside in urban areas with better health care. There is no obvious solution. But it is a genuine problem.

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