Palliative Space-Time: Expanding and Contracting Geographies of US Health CareCitation formats

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Palliative Space-Time: Expanding and Contracting Geographies of US Health Care. / Henry, Caitlin.

In: Social Science & Medicine, Vol. 268, 113377, 19.09.2020, p. 113377.

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Henry, Caitlin. / Palliative Space-Time: Expanding and Contracting Geographies of US Health Care. In: Social Science & Medicine. 2020 ; Vol. 268. pp. 113377.

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@article{2d942c97043c4f3fb7f465c5a8b3046c,
title = "Palliative Space-Time: Expanding and Contracting Geographies of US Health Care",
abstract = "Two important changes are happening in health care in the US. As hospitals close in high numbers, the geographies of health care services are changing. Also, the ageing of the population brings about new and complex care needs. These are not discrete trends, as ageing impacts the who, what, and where of care needs, and hospital closures remakes the geographies of where people overall access care. Developed out of research on the impacts of hospital restructuring on workers, patients, and communities, this paper aims to understand how health care financing, care needs for the ageing, and new geographies of health services are intertwined. To do so, I look back to 1980s policy changes to Medicare, the federal health insurance program for the elderly and disabled. In 1982, Congress made two important changes to Medicare. The program began covering hospice services, constituting an expansion of care, and the government drastically changed the way it reimburses providers, effectively a contraction of the program. I trace the impacts of these changes over the next decades through analysis of media coverage and secondary research on hospital budgets. Drawing on the concept of palliative space-time, I identify a contradictory logic of death at the center of this expansion and contraction of the health care system. This death logic works to destabilize an already uneven geography of health service. Yet, this crisis has the potential for more just geographies of health and care.",
keywords = "Death, Health finance, Health geography, Hospital closures, Medicare",
author = "Caitlin Henry",
year = "2020",
month = sep,
day = "19",
doi = "10.1016/j.socscimed.2020.113377",
language = "English",
volume = "268",
pages = "113377",
journal = "Social Science & Medicine",
issn = "1873-5347",
publisher = "Elsevier BV",

}

RIS

TY - JOUR

T1 - Palliative Space-Time: Expanding and Contracting Geographies of US Health Care

AU - Henry, Caitlin

PY - 2020/9/19

Y1 - 2020/9/19

N2 - Two important changes are happening in health care in the US. As hospitals close in high numbers, the geographies of health care services are changing. Also, the ageing of the population brings about new and complex care needs. These are not discrete trends, as ageing impacts the who, what, and where of care needs, and hospital closures remakes the geographies of where people overall access care. Developed out of research on the impacts of hospital restructuring on workers, patients, and communities, this paper aims to understand how health care financing, care needs for the ageing, and new geographies of health services are intertwined. To do so, I look back to 1980s policy changes to Medicare, the federal health insurance program for the elderly and disabled. In 1982, Congress made two important changes to Medicare. The program began covering hospice services, constituting an expansion of care, and the government drastically changed the way it reimburses providers, effectively a contraction of the program. I trace the impacts of these changes over the next decades through analysis of media coverage and secondary research on hospital budgets. Drawing on the concept of palliative space-time, I identify a contradictory logic of death at the center of this expansion and contraction of the health care system. This death logic works to destabilize an already uneven geography of health service. Yet, this crisis has the potential for more just geographies of health and care.

AB - Two important changes are happening in health care in the US. As hospitals close in high numbers, the geographies of health care services are changing. Also, the ageing of the population brings about new and complex care needs. These are not discrete trends, as ageing impacts the who, what, and where of care needs, and hospital closures remakes the geographies of where people overall access care. Developed out of research on the impacts of hospital restructuring on workers, patients, and communities, this paper aims to understand how health care financing, care needs for the ageing, and new geographies of health services are intertwined. To do so, I look back to 1980s policy changes to Medicare, the federal health insurance program for the elderly and disabled. In 1982, Congress made two important changes to Medicare. The program began covering hospice services, constituting an expansion of care, and the government drastically changed the way it reimburses providers, effectively a contraction of the program. I trace the impacts of these changes over the next decades through analysis of media coverage and secondary research on hospital budgets. Drawing on the concept of palliative space-time, I identify a contradictory logic of death at the center of this expansion and contraction of the health care system. This death logic works to destabilize an already uneven geography of health service. Yet, this crisis has the potential for more just geographies of health and care.

KW - Death

KW - Health finance

KW - Health geography

KW - Hospital closures

KW - Medicare

U2 - 10.1016/j.socscimed.2020.113377

DO - 10.1016/j.socscimed.2020.113377

M3 - Article

C2 - 32979774

VL - 268

SP - 113377

JO - Social Science & Medicine

JF - Social Science & Medicine

SN - 1873-5347

M1 - 113377

ER -