Department of Medicine, Division of General Internal Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
J Hosp Med. 2024 Sep;19(9):812-815. doi: 10.1002/jhm.13438. Epub 2024 Jun 19.
Despite the recent closure of several high-profile metropolitan hospitals, investigations into risk factors for metropolitan hospital closures have been limited. The goal of this study was to describe metropolitan hospitals that closed and compare them to metropolitan hospitals that remain open and micropolitan and rural hospitals that closed using American Hospital Association Annual Survey Data from 2010 to 2021. We independently verified hospitals reported as closed in the Annual Survey and examined the hospital characteristics associated with closure using bivariate statistics and logistic regression. We found that metropolitan hospitals that closed (n = 142) were more likely to be for-profit (66.9% vs. 29.7%, p < .0001; adjusted odds ratio [AOR]: 3.05, 95% confidence interval [CI]: 1.93, 4.81) and to come from a state that did not expand Medicaid (45.1% vs. 29.4%, p < .0001; AOR: 1.66, 95% CI: 1.16, 2.38). Policies tailored to metropolitan hospitals should be developed to identify at-risk hospitals and mitigate the effect of closures on patients, clinicians, and other stakeholders.
尽管最近几家知名大都市医院关闭，但对大都市医院关闭的风险因素的调查一直很有限。本研究的目的是描述关闭的大都市医院，并将其与仍在开放的大都市医院以及已关闭的大都市和农村医院进行比较，使用的是 2010 年至 2021 年美国医院协会年度调查数据。我们独立核实了年度调查中报告的已关闭医院，并使用双变量统计和逻辑回归检查了与关闭相关的医院特征。我们发现，已关闭的大都市医院（n=142）更有可能是营利性医院（66.9% 对 29.7%，p<0.0001；调整后的优势比[OR]：3.05，95%置信区间[CI]：1.93，4.81），且来自没有扩大医疗补助计划的州（45.1% 对 29.4%，p<0.0001；OR：1.66，95%CI：1.16，2.38）。应制定针对大都市医院的政策，以识别高风险医院，并减轻关闭对患者、临床医生和其他利益相关者的影响。
