Houlton hospital renovations reflect health care trends

HOULTON — In the past two years, Houlton Regional Hospital has undergone two restructurings of its staff and is now on the verge of completing a $5 million expansion and renovation project this summer.

While some people have often wondered why staff positions were eliminated at the same time the hospital was remodeling, the answer is simple: numbers.

“Business is up, but in fact, it’s a different type of business,” said Tom Moakler, the hospital’s chief executive officer. “You’re coming in and going out in one day.”

According to a recent survey completed for the Maine Hospital Association, while admissions to the hospital for acute illnesses and injuries have dropped by 7 percent, from 2,200 in 1993 to 2,048 last year, the number of ambulatory surgery cases has jumped 80 percent in thesame period, from 1,244 to 2,424.

The hospital serves an area of about 17 towns in three counties, with an estimated population of 17,695. According to the MHA survey, the service population for HRH is expected to increase by about 1.5 percent by 1999, compared with 1.2 percent for Maine as a whole.

For that reason, Moakler said he expects some of the current service trends at the hospital to continue.

The CEO said he expects emergency room visits, which have dropped from 14,705 in 1993 to 9,486 last year, to continue to decline. He said that number could hit 8,000 in couple of years.

As more people seek short-term, walk-in solutions for their health care needs, the renovations now being completed at the hospital have been planned to meet the new trends in health care that are being sought by them.

Improvements at the hospital include an expanded emergency department, including a four-bed trauma unit; a state-of-the-art cardiac rehabilitation unit; an expanded radiology department; and renovations to the laboratory.

With numbers going down, Moakler said there are concerns among some people in the state that there are now too many hospitals.

He said Wednesday that that line of thinking does not take into consideration the distances that people in Maine have to travel for hospital services. In the HRH coverage area, some patients have to travel as long as an hour to get to the hospital.

Aside from Houlton, the nearest hospitals are in Millinocket, 68 miles to the south, and in Presque Isle, 43 miles to the north.

“Rural health care is difficult at best because of the geographical layout,” said Moakler.

To those who say there are too many hospitals, he also draws attention to the economic role those facilities play in their host communities and regions.

According to the MHA survey, hospitals alone employed about 26,000 people in 1995. In addition, nonpayroll hospital expenditures totaled to $635 million for such things as food, utilities, supplies, taxes and capital improvements.

“What if there wasn’t a hospital in Houlton?” queried Moakler, immediately answering his own question. “It would be 300 people out of work and $7.5 million out of the economy.”