Rural Hospital Closures: A Scoping Review of Studies Published Between 1990 and 2020.

Area of Science:

• Health Services Research
• Rural Health
• Health Policy

Background:

• Since 2011, more rural hospitals have closed than opened in the U.S.
• A total of 334 rural hospitals closed between 1990 and 2020.
• Rural hospital closures present a significant challenge to healthcare access in underserved areas.

Purpose of the Study:

• To conduct a scoping review of peer-reviewed literature on rural hospital closures since 1990.
• To synthesize existing research across six key themes related to rural hospital closures.
• To identify gaps in the literature, particularly concerning vulnerable rural populations.

Main Methods:

• Systematic search of peer-reviewed studies published from 1990 onwards.
• Scoping review methodology to synthesize findings across diverse studies.
• Thematic synthesis of literature focusing on policy, precursors, economic, access, health, and definitional aspects.

Main Results:

• Rural hospital closures have increased, with facilities closing in the 2010s generally having more beds than those closing in the 1990s.
• Many studies reported null findings on the health impacts of closures, potentially due to varied definitions of "rural hospital closure."
• Significant gaps exist in understanding the specific impacts on rural communities of color and low-income populations.

Conclusions:

• The trend of rural hospital closures necessitates a deeper understanding of their multifaceted impacts.
• Future research should prioritize studies examining the effects on marginalized rural communities.
• Standardized definitions of rurality and hospital closures are needed for more consistent research findings.