了解农村医院关闭的影响:范围界定审查。

IF 3.1 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Journal of Rural Health Pub Date : 2023-10-11 DOI:10.1111/jrh.12801
Cody Lendon Mullens MD, MPH, J. Andres Hernandez MD, MBA, Jeevan Murthy BS, Steph Hendren MLIS, Whitney E. Zahnd PhD, Andrew M. Ibrahim MD, MSc, John W. Scott MD, MPH
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引用次数: 0

摘要

目的:农村医院正在以前所未有的速度关闭,未来两年将有数百家医院面临关闭的风险。正在制定和实施多项联邦政策,但对评估农村医院关闭及其影响的新兴文献缺乏显著的了解。我们进行了一次范围界定审查,以了解农村医院关闭的影响,为正在进行的政策辩论和研究提供信息。方法:图书馆教员设计了一种全面的搜索策略,使用PRISMA扩展对出版物进行范围审查。然后,两位合著者分别进行了标题和摘要筛选、全文综述和研究提取。研究结果:我们确定了5054篇独特的引文,并评估了236篇全文,以供纳入我们对农村医院关闭影响的文献的叙述性综合中。在我们的叙述综合中总共包含了20项原创研究。与农村医院关闭有关的不利影响的关键领域包括紧急医疗服务运输、当地经济、紧急护理和医院服务的可用性和利用率、门诊服务的可获得性、护理质量的变化以及劳动力和社区成员。然而,这些发现存在显著的异质性。结论:鉴于我们的研究结果在多个影响领域存在显著的异质性,我们主张采取量身定制的方法来减轻农村医院关闭对政策制定者的影响。我们还讨论了证据库中的关键知识差距,特别是在死亡率以外的质量衡量方面。综合这些发现将使政策制定者和研究人员能够了解并减轻农村医院关闭的危害。
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Understanding the impacts of rural hospital closures: A scoping review

Purpose

Rural hospitals are closing at unprecedented rates, with hundreds more at risk of closure in the coming 2 years. Multiple federal policies are being developed and implemented without a salient understanding of the emerging literature evaluating rural hospital closures and its impacts. We conducted a scoping review to understand the impacts of rural hospital closure to inform ongoing policy debates and research.

Methods

A comprehensive search strategy was devised by library faculty to collate publications using the PRISMA extension for scoping reviews. Two coauthors then independently performed title and abstract screening, full text review, and study extraction.

Findings

We identified 5054 unique citations and assessed 236 full texts for possible inclusion in our narrative synthesis of the literature on the impacts of rural hospital closure. Twenty total original studies were included in our narrative synthesis. Key domains of adverse impacts related to rural hospital closure included emergency medical service transport, local economies, availability and utilization of emergency care and hospital services, availability of outpatient services, changes in quality of care, and workforce and community members. However, significant heterogeneity existed within these findings.

Conclusions

Given the significant heterogeneity within our findings across multiple domains of impact, we advocate for a tailored approach to mitigating the impacts of rural hospital closures for policymakers. We also discuss crucial knowledge gaps in the evidence base—especially with respect to quality measures beyond mortality. The synthesis of these findings will permit policymakers and researchers to understand, and mitigate, the harms of rural hospital closure.

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来源期刊
Journal of Rural Health
Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
7.60
自引率
6.10%
发文量
86
审稿时长
>12 weeks
期刊介绍: The Journal of Rural Health, a quarterly journal published by the NRHA, offers a variety of original research relevant and important to rural health. Some examples include evaluations, case studies, and analyses related to health status and behavior, as well as to health work force, policy and access issues. Quantitative, qualitative and mixed methods studies are welcome. Highest priority is given to manuscripts that reflect scholarly quality, demonstrate methodological rigor, and emphasize practical implications. The journal also publishes articles with an international rural health perspective, commentaries, book reviews and letters.
期刊最新文献
Clinical outcomes and profitability following rural hospital mergers and acquisitions. Community responses and adaptations following the closure of a rural pharmacy and primary care facility. Weight status underestimation and weight management goals among adults in the rural South of the United States. Social needs and health outcomes in two rural Veteran populations. Association between obesogenic environments and childhood overweight/obesity across the United States: Differences by rurality.
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