Lacandi Gibson has trouble breathing.

This 33-year-old woman with multiple medical conditions is suffering from respiratory distress and is waiting for an ambulance. It arrived about 20 minutes after the emergency call.

The Cuthbert’s home where Gibson lives is less than a mile from the Southwestern Georgia Regional Medical Center, but an ambulance could not take her to this single-story brick hospital because it was three months ago, in October 2020. It was closed.

Instead, the emergency medical team loaded Gibson in an ambulance and drove her to a hospital in Eufra, Alabama more than 25 miles, where she was pronounced dead.

“They said it was a heart attack,” said Keira Davis, who lives in Gibson with her husband. “If the hospital was still open, it could have saved her.”

Cuthbert Hospital is one of 19 rural hospitals to close in 2020 in the United States. Maximum number Since the Cecil G. Sheps Health Services Research Center at the University of North Carolina began tracking data in 2005, such facilities have closed within a year.

In the past 10 years, Georgia has closed eight rural hospitals; only Texas and Tennessee have closed more. Data from the center showed that 86 of the 129 hospitals closed at the time were located in Texas and the Southeast.

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Healthcare professionals and Recent studies Said that the expansion of Medicaid helps keep hospitals functioning because it increases the number of low-income adults with health insurance. Since the implementation of the Medicaid program through the “Affordable Care Act” in 2014, the eight states that have closed the most rural hospitals have not chosen to expand their insurance plans in early 2021. In several of these states, including Georgia, the Republican-led government stated that such a step is too costly.

Georgia’s inaction in expanding the Medicaid program “may hurt us more than anyone else,” said Cuthbert Mayor Steve Watley, a Republican, who was in November He lost his re-election campaign in this city of about 3,400 people.

Certain communities may feel hospital closures more than others. Watley said Cuthbert’s “has incredible influence.” Randolph County Hospital Authority Chairman Watley said that the absence of an emergency room nearby means that every response of the ambulance will take it offline. Two to three hours.

Clifford Hanks of Cuthbert, 78, had a severe backache recently and had to drive to Eufaula’s emergency room. “The ambulance is too slow to be used,” Hanks said while sitting in a shop in Cuthbert Square. He said that the drive is rough.

According to the Sheps Center, several factors have contributed to the closure of hospitals across the country. George Pink, a senior researcher at the center, said the struggling rural hospitals admitted a large number of uninsured patients and chronically ill patients. “Their level of unpaid care is very high,” Pinker said, but there is not enough private insurance for patients, and private insurance reimburses hospitals at a higher cost than Medicaid and medical insurance.

The population in rural areas also tends to be aging, which will lead to an increase in the cost of care.

Pinker also said that it is difficult to recruit doctors in many rural counties where the population is declining. Many closed hospitals are facing infrastructure problems due to reduced funds used to maintain buildings and equipment.

“These hospitals have been losing money for years,” Pinker said.

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Researchers at the University of Washington found that the closure of rural hospitals has led to an increase in the death rate of inpatients in the area, while urban closures have no measurable impact. The reasons they cited included increased time for people to go to the hospital to see a doctor, and some medical service providers leaving the community when the hospital was closed.

According to reports, federal COVID relief funds have slowed the rate of hospital closures this year Brock Slabach, Chief Operating Officer of the National Rural Health Association. Despite this, the organization estimates that 453 rural hospitals (about a quarter of the total) are still at risk of closure.

“In the next few years, we may see 8 to 10 rural hospitals in Georgia close,” said CEO Jimmy Lewis. Hometown health, A rural hospital association in Georgia. “They are almost running out of cash.”

According to data from the Sheps Center, nationwide, rural hospitals that provide services to communities with large black populations are more likely to be financially troubled than rural hospitals in general. North Carolina Rural Health Research ProgramThe project’s research shows that among financially difficult rural hospitals, those serving areas with a higher black and/or Hispanic population are more likely to close. (Hispanic can be any race or combination of races.)

The closure of Cuthbert Hospital severely affected the black population in the area.

More than 60% of the residents in Randolph County are black. Residents in surrounding counties used to go to Cuthbert to see a doctor. The black population accounts for 47% or more.

In the area, black Americans, especially elderly people with diabetes and high blood pressure, are very worried about the closure of the hospital, said Charles Jackson, an employee at the CareConnect Health Center across the street from the hospital.

The community hopes to restore some medical services, if not completely restore the hospital. The Hospital Authority, the local Andrew College and a management company in Mississippi are collaborating to bid for USD 1 million and USD 10 million grants from the US Department of Agriculture. Our vision is to have an independent emergency room with a small number of beds. Watley said that if approved, the Hospital Authority still has “several millions of dollars” to support the funding. “Fifteen million dollars can do it,” Watley said.

U.S. Senator Jon Osoff (D-Ga.) is interested in the health care vacuum in Randolph County and is helping to identify opportunities in the private and public sectors to restore more medical services in the area. “The challenges faced by people in Randolph County are similar to those of rural healthcare,” Osoff said.

In downtown Cuthbert, the history of the Southwest Georgia Regional Medical Center unfolds on the walls of the old Randolph County Courthouse, which is now the seat of the Randolph County Chamber of Commerce.

The family of local pharmacist Carl Patterson founded the hospital in 1916, which was then named Patterson Hospital. Patterson said there were no full-time doctors in Randolph County after the facility closed.

Supporting hospitals financially is always difficult. It required a $10 million upgrade fee, and the surgery (a profitable service in some facilities) was not done there.

“Our hospital is not the best, but it is a means of stabilizing you. It helps a lot of people,” said Brenda Clark, who was born in the hospital and is now at the Cuthbert Health Center opposite the closed facility Work. She said that elderly people in need of care “cannot get in the car and drive to Eufaula or Albany.”

Rebecca White, executive director of the County Chamber of Commerce, said the closure of hospitals was “destructive” for businesses. Approximately 25% of Randolph County residents already live below the poverty line.

“In my opinion, this hospital is undoubtedly a life-saving straw,” said Dr. AS Ghiathi, a family doctor who has worked at the Southwest Georgia Regional Medical Center for more than 20 years. 64-year-old Ghiathi still lives in Randolph County, but mainly works at a Mercer Medical Clinic near Gainsburg, Clay County. There is no hospital in that county either.

He said the closure of Randolph County Hospital was “like a death”. “People are saddened by this loss. We want to pass this hospital to the next generation.”

Some residents of Randolph County said that the loss of hospitals was a factor in medical tragedies, such as the death of Lacandie Gipson, and could lead to other tragedies.

Jeanette Love, who lives in Sherman Township, Randolph County, is 67 years old. Her sister Susie Jackson said she died while waiting for an ambulance. It is called because love has difficulty breathing.

Jackson said that the ambulance in Randolph County was tied up, so he had to send an ambulance from another county to pick up Love. He suffered from chronic obstructive pulmonary disease and diabetes. When the ambulance drove to the wrong address, the delay became longer.

“It took an hour and a half or more,” Jackson said.

“It takes about 15 to 20 minutes to get to Cuthbert,” said Jackson, who drove from her Sherman’s home to Love’s to help her on July. “I have a car. I could have taken her to the hospital. She might have been saved.”

Instead, while the sisters were waiting, Jackson said, Love “sit next to me, put her head on my shoulder and died.”

Regarding the medical situation in Randolph County, Jackson said: “We are better than this.”

Kaiser Health News is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.