Mullner R M, Rydman R J, Whiteis D G
School of Public Health, University of Illinois, Chicago.
Hosp Health Serv Adm. 1990 Spring;35(1):121-37.
To test whether the facilities and services offered by rural hospitals can put them at risk of closure or protect against it, this study compares U.S. rural community hospitals that closed during the period 1980-1987, with a matched set of hospitals that remained open. Utilizing epidemiologic matched case-control methods and controlling for type of ownership, we found that (1) physical therapy, respiratory therapy, intensive care unit, computed tomography scanner, hospital auxiliary, and diagnostic radioisotope were negatively correlated with closure (i.e., had a protective effect); (2) the facilities and services correlated with risk of closure differed significantly between the pre-PPS (1980-1983) and post-PPS (1984-1987) periods; and (3) the presence of a skilled nursing or other long-term care unit was a significant risk factor during the period 1984-1987. Implications of these findings for hospital survival strategies and rural health care delivery under PPS are discussed.
为了检验农村医院提供的设施和服务是否会使其面临关闭风险或起到防范作用，本研究将1980 - 1987年期间关闭的美国农村社区医院与一组匹配的仍在营业的医院进行了比较。利用流行病学匹配病例对照方法并控制所有制类型，我们发现：（1）物理治疗、呼吸治疗、重症监护病房、计算机断层扫描仪、医院辅助科室和诊断放射性同位素与关闭呈负相关（即具有保护作用）；（2）与关闭风险相关的设施和服务在PPS之前（1980 - 1983年）和PPS之后（1984 - 1987年）期间存在显著差异；（3）在1984 - 1987年期间，设有专业护理或其他长期护理病房是一个显著的风险因素。本文讨论了这些研究结果对PPS下医院生存策略和农村医疗服务的影响。
