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Subtraction by addition.

Here we go again with another round of hospital building, just as many in the industry continue to repeat the usual line that the central Arkansas market has too many hospital beds. We do have too many beds, but maybe this type of expansion will lead to a more efficient health care delivery system five years or more down the road.

Columbia/HCA Healthcare Corp., which once aimed to buy a larger Little Rock hospital, will build its own smaller facility in the Springhill area of North Little Rock.

Columbia's plan calls for a $60 million facility with about 80 beds - rather miniature compared with the edifices built 25 or more years ago in the last big hospital infrastructure boom. In fact, Columbia will be basing its Springhill facility on a prototype it is using in a number of markets: Nashville, Tenn., and Las Colinas, Texas, to name two.

We have acknowledged the concern for too many empty hospital beds in this market and the fact that the patients would ultimately bear the cost for what seemed like an unneeded project, the Arkansas Heart Hospital. After all, all the doctors planning to work there also were already plying their trade at the other established medical centers in Little Rock. They still do, only they also own a piece of the Heart Hospital.

We see quite a conundrum. On one hand, common sense says that all the health care forces should be working together to produce the least expensive care possible, and that means a reduction of unnecessary space (or beds, or procedures) without a reduction of the necessary services. On the other hand, we wonder if more and more competition ultimately wouldn't drive prices down while service stayed high as the health care entities vied for patients.

Columbia is building its facility cater-cornered to Baptist Health's new Springhill hospital. (And talk about your well-thought-out plans, isn't Baptist helping pay for some of the new road construction in the area involving Interstate 40 and U.S. Highways 67-167? Columbia only has to build its hospital).

As one observer at the Columbia announcement noted, doctors angry with their treatment at the Baptist facility could just march right out the door and across the street to Columbia's facility, or vice versa.

Seriously, there may be some good to come out of all this recent hospital growth. If Columbia's new building is any indication of the future of health care, we endorse the endeavor. More hospitals will go to smaller facilities - Baptist will have half the inpatient beds as its older Baptist Memorial in North Little Rock - and bring care to underserved areas.

Do patients need to drive 15 miles to one major medical center? No, and they won't in the 21st century.

Pulaski County and the surrounding area have changed dramatically from the 1960s and early '70s, when the current Little Rock hospitals were being conceived. Sherwood and the northern end of North Little Rock have boomed. Cabot, Lonoke and other areas to the northeast have seen a sudden growth spurt. Ditto the southwest direction toward Benton.

Little Rock's population has moved out to the 'burbs, and health care must move with it. The large existing hospitals are aging rapidly, and renovation would cost almost as much as a newer, smaller facility in the areas that now need access. Note the millions spent on refurbishing the UAMS Medical Center to bring it up to speed while maintaining 300 or so beds.

If Columbia can eventually reduce the number of beds and the unnecessary cost of health care with this 80-bed facility of the future, then we're all for it.

The answer is the smaller, more accessible health care facilities for our more mobile population of today and tomorrow.
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Title Annotation:expansion moves of health care companies in central Arkansas
Publication:Arkansas Business
Article Type:Editorial
Date:Jun 16, 1997
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