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“Dead in the water” was her por­trayal of what would have been the chances of keep­ing in­pa­tient beds in Ch­ester­town had Shore Re­gional Health taken a dif­fer­ent tack.

There ap­pears to have been a sub­tle shift in the re­la­tion­ship be­tween Shore Re­gional Health and ad­vo­cates for keep­ing in­pa­tient beds in Ch­ester­town, or at least Mizeur sees it that way. She la­beled it “con­sen­sus build­ing.” “We’re all see­ing the hori­zon from the same per­spec­tive,” she said.

The white pa­per in­cludes an eco­nomic im­pact re­port that shows Shore Re­gional Health gen­er­ated $309.1 mil­lion in fis­cal year 2016. Shore Med­i­cal Cen­ter at Ch­ester­town gen­er­ated $53.6 mil­lion.

Shore Re­gional Health em­ploy­ees 2,252 peo­ple; 256 of them, or 11 per­cent, work at the Ch­ester­town hos­pi­tal. By com­par­i­son, Shore Med­i­cal Cen­ter at Eas­ton, where UMMS and Shore Re­gional Health want to build a new re­gional hos­pi­tal, gen­er­ated $190.6 mil­lion in rev­enue and em­ploy­ees 1,203 peo­ple.

Also in FY 2016, Shore Re­gional Health re­ported 10,7669 to­tal hos­pi­tal ad­mis­sions, 1,596 of which were to the Ch­ester­town hos­pi­tal and 7,412 were at Eas­ton. Of the 79,064 emer­gency room vis­its, 14,259 were in Ch­ester­town com­pared to the 27,987 in Eas­ton.

Shore Re­gional Health’s white pa­per makes a com­pelling ar­gu­ment for main­tain­ing in­pa­tient beds in Ch­ester­town.

Be­cause of Kent County’s ge­o­graphic iso­la­tion and lack of pub­lic trans­porta­tion, get­ting to a hos­pi­tal in Eas­ton or An­napo­lis or Elk­ton is chal­leng­ing. The es­ti­mated drive time from Rock Hall to Eas­ton is 65 min­utes, more if you get be­hind school buses or farm equip­ment on sec­on­dar y roads, ac­cord­ing to the white pa­per.

Kent County also has an ag­ing pop­u­la­tion; 24 per­cent of its res­i­dents are older than 65. Hav­ing fam­ily and friends who can visit dur­ing a hos­pi­tal stay is an im­por­tant com­po­nent in their re­cov­ery. Dis­tance and lack of trans­porta­tion make that less likely to hap­pen.

Hav­ing fam­ily close by also is im­por­tant for sin­gle par­ents and their young chil­dren.

As re­ported by the Mary­land Depart­ment of Health and Men­tal Hy­giene,

one of the top five health care is­sues in Kent County is poverty — along with af­ford­abil­ity of health care, obe­sity, lack of phys­i­cal ac­tiv­ity and smok­ing dur­ing preg­nancy.

Kent is the only Mid-Shore county to have poverty listed as a key health care is­sue.

Low health lit­er­acy is a par­tic­u­lar prob­lem for peo­ple in poverty, ac­cord­ing to a study that Shore Re­gional Health cited. In Kent County, more than 50 per­cent of stu­dents qual­ify for free or re­duced-priced meals.

Low or limited health lit­er­acy is as­so­ci­ated with a lower like­li­hood of us­ing pre­ven­tive health ser vices, a greater like­li­hood of tak­ing medicines in­cor­rectly and poor health sta­tus.

Ja­cobs, O’Con­nor and Kareiva, in sep­a­rate in­ter­views, talked about the im­por­tance of hav­ing an in­ten­sive care unit — for the well-be­ing of pa­tients and the sus­tain­abil­ity of the hos­pi­tal.

“If I’m do­ing a sim­ple case and the pa­tient has a heart at­tack, they need an ICU. You can’t just put them in an am­bu­lance and ship them to Eas­ton,” Kareiva said.

“We def­i­nitely need in­ten­sive care. If not, you’ll have to get rid of the OR. And once you get rid of the OR, other ser­vices will fol­low,” she said.

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