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Local hospitals expanding, demand increasing

Local hospitals expanding, demand increasing

As the population gets older and larger, in number and in girth, Boone Hospital Center and the University of Missouri hospitals expect by 2010 to be treating several thousand more patients per year and to have started major building projects to expand their space for beds, treatments and parking.
The hospitals also face challenges related to reimbursements, increasing costs and a shortage of doctors and nurses, according to Boone Hospital President Dan Rothery and University of Missouri Health Care CEO Jim Ross, who presented an overview of the local health care system during the Economic Outlook Conference on Dec. 4.
Workers currently are building the utility infrastructure for a three-phase expansion of the University Hospital complex that will cost more than $850 million. Construction is scheduled to begin in January on an orthopedic center and next spring on a patient tower, a cancer center and a 2,000-car parking garage, Ross said. Boone Hospital Center plans to start construction of its parking garage in January and next December will begin building a new patient tower, scheduled to be ready for patients in December 2010, Rothery said.
Overall, here’s the economic impact of the local hospitals by the numbers: They have 5,929 full-time employees, with payroll and benefits totaling $310 million—not including physicians with hospital privileges. The average salary is $41,500, and the capital investment is $52 million. In the past two years, 175 new physicians have been recruited to Columbia. The number of practicing physicians in Columbia is 652, and number of hospital beds is 1,020.
The number of patient discharges from the Boone and University hospitals in fiscal year 2007 was 38,679, and 23,661 were patients from outside Boone County.
The number of hospital patient discharges at Boone Hospital Center was 16,516 in 2006, but that figure is expected to jump above 20,000 in 2010 and up to 22,300 by 2016. 
Rothery said there was a point last year when Boone Hospital ran out of space and had to spread the message to emergency service providers: “Don’t come to Boone; we have no beds.”  
Boone Hospital now has 338 beds, 150 in private rooms and 188 in semi-private, with a 75 percent occupancy rate. When the new building for inpatients is finished, it will have 364 beds in private rooms. Because it’s easier to fill private rooms, the estimated occupancy rate is 90 percent, meaning the effective yield would be an extra 74 beds.
The area’s growing population and the entry of baby boomers into senior status will increase health care needs, according to the hospital executives. During the next five years, the population in Columbia, now about 95,000, will increase an estimated 5.7 percent. But the population of Columbians 65 and older is expected to increase 20 percent, from 8,757 to 9,571.
The area’s high rate of smoking and the obesity epidemic also are contributing to chronic disease and will increase hospital treatment demands, Ross and Rothery said. Twenty-four percent of Missouri residents were smokers in 1990, three points higher than the national average. Adult obesity in Missouri rose from 12 percent of the population in 1990 to 25 percent in 2004. More recent figures from the state health department said there were 337,000 obese Missourians in 2005, compared with about 300,000 two years earlier.   
Reimbursements also are expected to become more challenging in the coming years, they said. High deductible plans are shifting costs to employees, Medicare rolls are increasing, and the number of uninsured patients is rising.
Ross pointed out the vulnerability of hospitals to changes in laws involving government programs such as Medicare.
“With one stroke of the pen,” he said, “we can have multi-million-dollar changes.”

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