Healthcare works best when physicians and hospitals work together. The result is better, less expensive care.

This was the vision in the 1990s when MaineHealth was born, and in 2007 when Lincoln County Healthcare was created. The trustees who founded these organizations knew this idea would require a new way of thinking and fundamental changes in how we work.

Since 2005, Lincoln County residents have averaged approximately 4,000 inpatient admissions per year. Fewer than 12 percent of the Lincoln County residents are admitted to a Maine hospital in any given year, and that percentage is decreasing even as the county’s population is aging. That means that more than 88 percent of Lincoln County residents receive their health care entirely on an outpatient basis.

In a recent letter to the editor in this newspaper, the Boothbay Region Health and Wellness Foundation claimed that the number of inpatients beds in Lincoln County (25 after the changes in October) will mean that Lincoln County will have “… a ratio of .04 beds per 1,000 people, which is equivalent to Afghanistan.” Basic mathematics indicates that Lincoln County would need 625,000 residents for there to be a ratio of .04 hospital beds per 1000 population. Even if this was a typographical error, .4 beds per 1,000 would require a county population of 62,500. (According to the 2010 census there are 34,457 Lincoln County residents.)

In 2011 Lincoln County residents were admitted to hospitals 3,650 times. With continued improvements in healthcare and the anticipated reduction in the county’s population, this figure should continue to shrink. Fewer, yet sicker patients are being admitted to hospitals, and these patients often require the clinical expertise and technology only available in larger hospitals. This largely explains why almost two-thirds of Lincoln County inpatients are admitted to hospitals outside Lincoln County.

Over the last three years, the annual average acute care daily census for both hospitals (combined) has not exceeded 20 patients. And the demand placed on inpatient capacity by seasonal residents is minimal. We only need to look at current experience for the months of July (20.6) and August (21.0), which are only slightly above the annual average daily census of 19.5. The proposed 25-bed acute care capacity should easily accommodate the acute care inpatient demand placed on Lincoln County Healthcare.

Numbers aside, using inpatient beds per capita is no way to measure the value of a healthcare system to a community. This measure does not recognize the innovations and improvements over the decades that have resulted in higher quality care delivered on an outpatient basis or in the primary care physician’s office.

There is less need for hospital beds because we are getting better at treating and managing disease on an outpatient basis and keeping people out of the hospital. And as we continue to make changes to the way we deliver care now, we can do even more to keep people in Lincoln County healthier while charging them less.

As we’ve seen over this past year, change is not easy and emotions have run high. It’s vitally important for our organization and members of the community to work together to achieve a vision for a healthier community. To get there we must all avoid exaggeration and language that impedes our ability to work together.

The trustees, administration and clinical leadership at Lincoln County Healthcare strongly believe that the future of healthcare delivery and a healthier community is not patients in hospital beds. Instead, we are committed to doing everything possible to keep the people of our region well, independent and out of the hospital.