The effect of rural hospital closures on community economic health
The effect of rural hospital closures on community economic health
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DOI：
10.1111/j.1475-6773.2005.00497.x
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发表时间：
2006-04-01
影响因子：
3.4
通讯作者：
Poley, S
中科院分区：
文献类型：
--
作者：
Holmes, GM;Slifkin, RT;Poley, S
目标。探讨农村医院关闭对地方经济的影响。数据源。美国人口普查局，OSCAR，医疗保险成本报告，以及了解当地医院关闭情况的个人调查。研究设计。1990-2000年县一级的经济数据与关于医院关闭的信息相结合。研究样本仅限于在样本期间经历关闭的农村县。采用纵向回归方法估计医院关闭对人均收入、失业率和其他社区经济指标的影响。模型包括领先和滞后的关闭条件，允许关闭前的经济低迷，以及社区充分实现关闭的时间。数据收集。通过联系各州医院协会收集有关关闭医院的信息，并将收集到的信息与美国医院协会档案和监察长报告中所载的信息进行核对。主要的发现。结果表明，社区唯一一家医院的关闭使人均收入减少了703美元（p < 0.05）或4% (p < 0.05)，失业率增加了1.6个百分点（p < 0.01）。在有其他医院护理来源的社区，关闭医院没有长期的经济影响，尽管在关闭后的2年里，收入有所下降。在设计或改变影响医院财务状况的法规时，应考虑到医院关闭对当地经济的影响。
Objective. To examine the effect of rural hospital closures on the local economy.Data Sources. U.S. Census Bureau, OSCAR, Medicare Cost Reports, and surveys of individuals knowledgeable about local hospital closures.Study Design. Economic data at the county level for 1990-2000 were combined with information on hospital closures. The study sample was restricted to rural counties experiencing a closure during the sample period. Longitudinal regression methods were used to estimate the effect of hospital closure on per-capita income, unemployment rate, and other community economic measures. Models included both leading and lagged closure terms allowing a preclosure economic downturn as well as time for the closure to be fully realized by the community.Data Collection. Information on closures was collected by contacting every state hospital association, reconciling information gathered with that contained in the American Hospital Association file and OIG reports.Principal Findings. Results indicate that the closure of the sole hospital in the community reduces per-capita income by $703 (p < 0.05) or 4 percent (p < 0.05) and increases the unemployment rate by 1.6 percentage points (p < 0.01). Closures in communities with alternative sources of hospital care had no long-term economic impact, although income decreased for 2 years following the closure.Conclusions. The local economic effects of a hospital closure should be considered when regulations that affect hospitals' financial well-being are designed or changed.