Ailing from the recession, many U.S. hospitals have had to begin making cuts to patient services and laying off staff, an industry survey found. In previous recessions the healthcare industry has held up well, but this time hospitals and other healthcare businesses are hurting. Besieged by financial pressures including more needy and uninsured people, hospitals now are making tough decisions that affect their patients and communities. The American Hospital Association found 22% of hospitals that responded to its March survey have reduced services since the economic crisis began in September. Those services range from outpatient clinics and behavioral health programs to patient education and home health care after discharge.