Abstract
Hospital closure, a devastating event in the life of small communities, can have long-lasting medical, economic, and psychological consequences. This study focuses on a 1991 closure that occurred in the rural North Dakota town of Beach that left local residents 40 and 61 miles away from the nearest hospitals. Two hundred residents of the hospital's former service area were selected via systematic random sampling to share their perceptions on the causes and effects of closing their local hospital. According to respondents, this hospital closure was caused by a number of influences, with the most commonly cited being under-utilization of services by local residents, exacting government rules and regulations, doleful economic climate, dwindling population, poor and unstable local physician care, and poor management of hospital matters. Findings further indicated that Beach area residents were most concerned with poor access to emergency medical care as a result of the closing. Area dwellers perceived that the hospital closure's aftermath would include the loss of local jobs, further declines in the local economy, the suffering of elderly and children, transportation problems, and out-migration of some area residents. These concerns, coupled with the notable decrease in hospital care access, motivated many area residents to think of solutions to these problems rather than to place blame on others for the closure.
Similar content being viewed by others
References
Hart, LG, Pirani, MJ, Rosenblatt, RA, Causes and consequences of rural small hospital closures from the perspective of mayors.J Rural Health 7:222–245, 1991.
Burda, D, AHA's tally of hospital closings drops again.Mod Healthe 23:3, 1993.
Mullner, R, McNeil, D, Rural and urban hospital closures: A comparison.Health Aff 5:131–141, 1986.
Samuels, S, Cunningham, JP, Choi, C, The impact of hospital closures on travel time to hospitals.Inquiry 28:194–199, 1989.
Hendricks, A, Alberts, D,Closures of Hospitals Between 1980 and 1987. Center for Health Economics Research, Needham, MA. Contract report prepared for the Health Care Financing Administration, U.S. Department of Health and Human Services, Rockville, MD, 1989.
U.S. Congress, General Accounting Office,Rural Hospitals: Federal Efforts Should Target Areas Where Closures Would Threaten Access to Care. (GAO-HRD-91-41). Washington, DC: U.S. Government Printing Office, 1991.
Burda, D, Hospital closures aren't closing off access to care.Mod Healthe 22:18–20, 1992.
U.S. Department of Health and Human Services, Office of the Inspector General.Hospital Closure: 1987. Washington, DC: Office of the Inspector General, 1989, pp. 11–13.
American Hospital Association,Rural Hospital Closure: Management and Community Implications. Chicago, IL: American HospitalAssociation, 1989, Pp. 34–35.
U.S. General Accounting Office,Rural Hospitals: Closures and Issues of Access. (GAO-HRD-91-46). Washington, DC: U.S. Government Printing Office, 1991, P. 1.
Bindman, AB, Keane, D, Lurie, N, A public hospital closes: Impact on patients' access to care and health status.J Am Med Assoc 264:2899–2904, 1990.
Hernandez, R, Kaluzny, A, Hospital closure: A review of current and proposed research.Health Serv Res, 18:419–436, 1993.
Merlis, M,Rural Hospitals. U.S. Congress, Congressional Research Services, Washington, DC, no. 89–296 EPW, 1989.
Welch, HG, Larson, EB, Welch, WP, Can distance be a proxy for severity-of-illness? A comparison of hospital costs in distant and local patients.Health Serv Res 28: 441–458, 1993.
Aday, L, Economic and non-economic barriers to the use of needed medical services.Med. Care 13:447–456, 1975.
Aday, L, Anderson, R, The national profile of access to medical care: Where do we stand?Am J Public Health 74: 1331–1339, 1984.
Hernandez, R, Kaluzny, A, Hospital closure: A review of current and proposed research.Health Serv Res 18: 419–436, 1983.
McNeil, D, Williams, R, Wide range of causes found for hospital closure.Hospitals 52:76–81, 1978.
Mullner, R, Byre, C, Kubal, J, Hospital closure in the United States, 1976–1980: A descriptive overview.Health Serv Res 18:437–450, 1983.
Cleverley, WO, After the fall: Reasons behind 1989 hospital closings.Healthc Financ Manage July:22–24, 1990.
Mullner, RM, Rydman, RJ, Whiteis, DG, Rich, RF, Rural community hospitals and factors correlated with their risk of closing.Public Health Rep 104:315–325, 1989.
U.S. Congress,The Rural Health Care Challenge. Washington, DC: U.S. Government Printing Office, 1988, Pp. 1–11.
U.S. Congress, Office of Technology Assessment,Health Care in Rural America. Washington, DC: U.S. Government Printing Office, 1990, P. 6.
Ludtke, RL, Ahmed, KA. Sparse populations and patterns of health service use.Tex J Rural Health. In Press, 1994.
Author information
Authors and Affiliations
Additional information
This research was supported in part by funding from the Office of Rural Health Policy, Health Resources and Services Administration, U.S. Department of Health and Human Services (Grant No. CSR000005-02-0).
Rights and permissions
About this article
Cite this article
Muus, K.J., Ludtke, R.L. & Gibbens, B. Community perceptions of rural hospital closure. J Community Health 20, 65–73 (1995). https://doi.org/10.1007/BF02260496
Issue Date:
DOI: https://doi.org/10.1007/BF02260496