Abstract：
To compile the literature on the effects of rural hospital closures on the community and summarize the evidence, specifically the health and economic impacts, and identify gaps for future research.
A systematic review of the relevant peer-reviewed literature, published from January 2005 through December 2021, included in the EMBASE, CINAHL, PubMed, EconLit, and Business Source Complete databases, as well as \"gray\" literature published during the same time period. A total of 21 articles were identified for inclusion.
Over 90% of the included studies were published in the last 8 years, with nearly three-fourths published in the last 4 years. The most common outcomes studied were economic outcomes and employment (76%), emergent, and non-emergent transportation, which includes transport miles and travel time (42.8%), access to and supply of health care providers (38%), and quality of patient outcomes (19%). Eighty-nine percent of the studies that examined economic impacts found unfavorable results, including decreased income, population, and community economic growth, and increased poverty. Between 11 and 15.7 additional minutes were required to transport patients to the nearest emergency facility after closures. A lack of consistency in measures and definition of rurality challenges comparability across studies.
The comprehensive impact of rural hospital closures on communities has not been well studied. Research shows predominantly negative economic outcomes as well as increased time and distance required to access health care services. Additional research and consistency in the outcome measures and definition of rurality is needed to characterize the downstream impact of rural hospital closures.
A systematic review of the relevant peer-reviewed literature, published from January 2005 through December 2021, included in the EMBASE, CINAHL, PubMed, EconLit, and Business Source Complete databases, as well as \"gray\" literature published during the same time period. A total of 21 articles were identified for inclusion.
Over 90% of the included studies were published in the last 8 years, with nearly three-fourths published in the last 4 years. The most common outcomes studied were economic outcomes and employment (76%), emergent, and non-emergent transportation, which includes transport miles and travel time (42.8%), access to and supply of health care providers (38%), and quality of patient outcomes (19%). Eighty-nine percent of the studies that examined economic impacts found unfavorable results, including decreased income, population, and community economic growth, and increased poverty. Between 11 and 15.7 additional minutes were required to transport patients to the nearest emergency facility after closures. A lack of consistency in measures and definition of rurality challenges comparability across studies.
The comprehensive impact of rural hospital closures on communities has not been well studied. Research shows predominantly negative economic outcomes as well as increased time and distance required to access health care services. Additional research and consistency in the outcome measures and definition of rurality is needed to characterize the downstream impact of rural hospital closures.
摘要：
目的：收集有关农村医院关闭对社区影响的文献，并总结证据，特别是对健康和经济的影响，并确定未来研究的差距。
方法：对相关同行评审文献的系统回顾，2005年1月至2021年12月出版，包括在EMBASE中，CINAHL,PubMed,EconLit,和业务来源完整数据库，以及同期出版的“灰色”文献。总共确定了21篇文章。
结果：超过90%的纳入研究是在过去8年发表的，近四分之三在过去的四年里出版。研究的最常见结果是经济结果和就业（76％），emergent,和非紧急运输，其中包括运输里程和旅行时间(42.8%)，获得和供应医疗保健提供者(38%)，和患者预后质量（19%）。百分之八十九的调查经济影响的研究发现了不利的结果，包括收入减少，人口,和社区经济增长，贫困加剧。关闭后，将患者运送到最近的紧急设施还需要11到15.7分钟。在衡量和定义上缺乏一致性，挑战了研究之间的可比性。
结论：农村医院关闭对社区的综合影响尚未得到很好的研究。研究表明，主要是负面的经济结果，以及获得医疗保健服务所需的时间和距离增加。需要在结果测量和农村定义方面进行更多的研究和一致性，以表征农村医院关闭的下游影响。
方法：对相关同行评审文献的系统回顾，2005年1月至2021年12月出版，包括在EMBASE中，CINAHL,PubMed,EconLit,和业务来源完整数据库，以及同期出版的“灰色”文献。总共确定了21篇文章。
结果：超过90%的纳入研究是在过去8年发表的，近四分之三在过去的四年里出版。研究的最常见结果是经济结果和就业（76％），emergent,和非紧急运输，其中包括运输里程和旅行时间(42.8%)，获得和供应医疗保健提供者(38%)，和患者预后质量（19%）。百分之八十九的调查经济影响的研究发现了不利的结果，包括收入减少，人口,和社区经济增长，贫困加剧。关闭后，将患者运送到最近的紧急设施还需要11到15.7分钟。在衡量和定义上缺乏一致性，挑战了研究之间的可比性。
结论：农村医院关闭对社区的综合影响尚未得到很好的研究。研究表明，主要是负面的经济结果，以及获得医疗保健服务所需的时间和距离增加。需要在结果测量和农村定义方面进行更多的研究和一致性，以表征农村医院关闭的下游影响。
