With all the talk of budget cuts in New Jersey, the state's hospitals are making their case that they're suffering in the economic downturn just like other businesses. To bolster their argument, the New Jersey Hospital Association released results of a new survey yesterday that revealed multiple signs of financial strain.

The American Hospital Association and the Hospital and Healthsystem Association of Pennsylvania already have used similar surveys to argue for robust government funding, even though health care seems to be one of the economy's stronger sectors.

Not only are hospitals crucial for health care, but they are also often the biggest employers in their communities, said Sean Hopkins, senior vice president of health economics at the New Jersey Hospital Association. "Now is not the time to forsake some of your largest employers that also happen to be the fabric of the health-care safety net in the state," he said.

Thirty-seven of the state's 74 hospitals responded to the survey. The results were presented in aggregate and were short on details.

The hospitals said their total margins fell from 3.7 percent in 2007 to minus 4.5 percent last year. Forty-five percent said they had laid off from six to 140 people in 2008. Twenty-one percent expect layoffs this year, ranging from 10 to 120 employees.

More than three-quarters said they had more charity care and emergency room patients. In 60 percent of hospitals, elective procedures were down 2 percent to 20 percent.

Hopkins said eight hospitals had closed in the last year. That, coupled with people who had lost employer-sponsored insurance along with their jobs, could explain why ER visits and charity care are up. Hospitals were not asked whether they had seen an increase in elective procedures, so it is not known whether some might be benefiting from the closures.

Seventy-two percent of the hospitals said charitable contributions were down. Hopkins said declines of 10 percent to 25 percent were common.

Contact staff writer Stacey Burling at 215-854-4944 or sburling@phillynews.com.