Understanding the impacts of rural hospital closures: A scoping review.
Understanding the impacts of rural hospital closures: A scoping review.
复制标题
了解农村医院关闭的影响：范围界定审查。
DOI：
10.1111/jrh.12801
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Scott,JohnW
中科院分区：
文献类型：
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作者：
Mullens,CodyLendon;Hernandez,JAndres;Murthy,Jeevan;Hendren,Steph;Zahnd,WhitneyE;Ibrahim,AndrewM;Scott,JohnW
农村医院正以前所未有的速度关闭，未来两年还有数百家面临关闭的风险。多个联邦政策正在制定和实施，而没有一个显着的理解新兴文献评估农村医院关闭及其影响。我们进行了一个范围审查，了解农村医院关闭的影响，以告知正在进行的政策辩论和research.MethodsA综合搜索策略，图书馆教师整理出版物使用的PRISMA扩展范围审查。两名合著者，然后独立进行标题和摘要筛选，全文回顾，和study extraction.FindingsWe确定了5054独特的引文和评估236全文可能纳入我们的叙述性合成的文献对农村医院关闭的影响。在我们的叙述性综合中共纳入了20项原始研究。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、地方经济、紧急护理和医院服务的提供和利用、门诊服务的提供、护理质量的变化以及劳动力和社区成员。然而，显着的异质性存在于这些findings.ConclusionsGiven的显着异质性在我们的研究结果跨多个领域的影响，我们主张量身定制的方法来减轻农村医院关闭的政策制定者的影响。我们还讨论了证据基础中的关键知识缺口，特别是在死亡率以外的质量指标方面。这些研究结果的综合将使政策制定者和研究人员能够理解和减轻农村医院关闭的危害。
PurposeRural 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.MethodsA 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.FindingsWe 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.ConclusionsGiven 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.