J Health Care Poor Underserved. 2024;35(2):439-464.
Between 1990 and 2020, 334 rural hospitals closed in the United States, and since 2011 hospital closures have outnumbered new hospital openings. This scoping review evaluates peer-reviewed studies published since 1990 with a focus on rural hospital closures, synthesizing studies across six themes: 1) health care policy environment, 2) precursors to rural hospital closures, 3) economic impacts, 4) effects of rural hospital closures on access to care, 5) health and community impacts, and 6) definitions of rural hospitals and communities. In the 1990s, rural hospitals that closed were smaller, while rural hospitals that closed in the 2010s tended to have more beds. Many studies of the health impacts of rural hospital closures yielded null findings. However, these studies differed in their definitions of "rural hospital closure." Given the accelerated rate of hospital closures, more attention should be paid to hospitals that serve rural communities of color and low-income communities.
1990 年至 2020 年间，美国有 334 家农村医院关闭，自 2011 年以来，医院关闭的数量超过了新医院的开业数量。本范围综述评估了自 1990 年以来发表的同行评议研究，重点关注农村医院的关闭，综合了六个主题的研究：1）医疗保健政策环境；2）农村医院关闭的前兆；3）经济影响；4）农村医院关闭对获得医疗服务的影响；5）健康和社区影响；6）农村医院和社区的定义。在 20 世纪 90 年代，关闭的农村医院规模较小，而在 21 世纪 10 年代关闭的农村医院往往拥有更多的床位。许多关于农村医院关闭对健康影响的研究都没有发现任何结果。然而，这些研究在“农村医院关闭”的定义上存在差异。鉴于医院关闭的速度加快，应该更加关注为农村有色人种社区和低收入社区服务的医院。
