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And if it is still needed, is it economically viable?

The effort to scale back inpatient care is occurring within some of the nation’s most prestigious nonprofit hospitals.

Today, the same procedure is done laparoscopically, through a much smaller incision, resulting in a recovery time of about 24 hours.

“Some people don’t even stay in the hospital,” Sadosty said.

Across the country, conglomerates that control an increasing share of the market are changing their business models, consolidating services in one regional “hub” hospital and cutting them from others.

Hospital executives see these cuts as sound business decisions, and say they are the inevitable consequence of changes in how people are using medical services.

Doctors and nurses leave and buildings are shuttered, maybe demolished. These facilities become, in essence, outpatient clinics.

In Massachusetts, sprawling Partners Health Care said it will shut the only hospital in Lynn, a city of 92,000 people near Boston, and instead direct patients to its hospital in neighboring Salem.

Only urgent care and outpatient services will remain in Lynn.

It represents a slow-moving but seismic shift in the idea of the community hospital — the place down the street where you could go at any hour, and for any need.

Does the need for that hospital still exist, or is it a nostalgic holdover?

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