了解农村医院关闭的影响:一个范围审查
Cody Lendon Mullens1,2, J Andres Hernandez3, Jeevan Murthy4
1Department of Surgery, University of Michigan, Ann Arbor, Michigan.
概括
农村医院关闭对紧急服务,经济和护理准入产生负面影响. 政策制定者需要量身定制的战略来解决这些伤害和知识差距.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 农村卫生政策 农村卫生政策
- 医疗保健经济学 医疗保健经济学
背景情况:
- 农村医院面临前所未有的关闭率,威胁到医疗保健的准入.
- 联邦政策在没有完全了解关闭影响的情况下出现.
- 本研究解决了关于农村医院关闭的基于证据的政策的需要.
研究的目的:
- 对有关农村医院关闭影响的文献进行范围审查.
- 为政策辩论和未来关于农村医疗保健可持续性的研究提供信息.
- 确定与农村地区医院关闭相关的不良影响和知识差距.
主要方法:
- 使用PRISMA扩展用于范围审查的全面文献搜索.
- 独立的标题/摘要选,全文审查和两个研究人员的数据提取.
- 20项原始研究的叙述综合从5054个独特的引用中确定.
主要成果:
- 农村医院关闭会对紧急医疗服务,当地经济以及获得紧急和门诊护理的机会产生不利影响.
- 影响包括护理质量的变化,劳动力稳定性和社区福祉.
- 在确定的影响领域中观察到显著的异质性.
结论:
- 建议采取量身定制的政策方法,以减轻农村医院关闭的各种影响.
- 存在关键的知识差距,特别是在死亡率以外的质量指标方面.
- 综合的研究结果将有助于政策制定者和研究人员理解和解决农村医院关闭的危害.
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