دورية أكاديمية
The effect of rural hospital closures on maternal and infant health.
| العنوان: | The effect of rural hospital closures on maternal and infant health. |
|---|---|
| المؤلفون: | Durrance C; La Follette School of Public Affairs, University of Wisconsin-Madison, Madison, Wisconsin, USA., Guldi M; Department of Economics, University of Central Florida, Orlando, Florida, USA., Schulkind L; Department of Economics, Belk College of Business, University of North Carolina at Charlotte, Charlotte, North Carolina, USA. |
| المصدر: | Health services research [Health Serv Res] 2024 Apr; Vol. 59 (2), pp. e14248. Date of Electronic Publication: 2023 Oct 15. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Blackwell Country of Publication: United States NLM ID: 0053006 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1475-6773 (Electronic) Linking ISSN: 00179124 NLM ISO Abbreviation: Health Serv Res Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Malden, MA : Blackwell Original Publication: Chicago, Hospital Research and Educational Trust. |
| مواضيع طبية MeSH: | Health Facility Closure* , Rural Population*, Pregnancy ; Infant ; Female ; Humans ; United States ; Infant Health ; Hospitals, Rural ; Infant Death |
| مستخلص: | Objective: To evaluate the effect of rural hospital closures on infant and maternal health outcomes. Data Sources and Study Setting: We used restricted National Vital Statistics System birth and linked birth and infant death data, merged with county-level hospital closures from the Sheps Center for the period 2005-2019. Study Design: We used difference-in-difference and event study methods, employing new estimators that account for staggered treatment timing. Our key outcome variables were prenatal care initiation; birth outcomes (<2500 g; <1500 g; <37 weeks; <28 weeks; 5-min Apgar); delivery outcomes (cesarean, induction, hospital birth); and infant death (<1 year of birth; <=30 days of birth; <=7 days of birth; <= 1 day after birth). Data Collection/extraction Methods: The analysis covered all births in the United States in rural counties (by rurality: all, most, moderately rural). Principal Findings: We found evidence that fewer individuals delivered in their county of residence after a hospital closure, and this was most pronounced for residents of the most rural counties (29%-52% decline (p < 0.01) in the likelihood of delivering in their residence county). We found that hospital closures worsen prenatal, infant, and delivery outcomes for residents of moderately rural counties but improve those outcomes for those in the most rural counties. In moderately rural counties, low birth weight births increased by 10.4% (p < 0.01). We found suggestive evidence of decreased infant deaths in the most rural counties. This pattern of findings is consistent with closures leading residents of the most rural counties to seek care in a different county and residents of moderately rural counties to seek care at a different hospital in the same county. Conclusions: Loss of hospital care has meaningful effects on the rural populations; investigating rural counties in aggregate may miss nuanced differences in the effects on the margin of rurality. (© 2023 Health Research and Educational Trust.) |
| References: | JAMA. 2022 Jul 26;328(4):397. (PMID: 35881129) JAMA. 2018 Mar 27;319(12):1239-1247. (PMID: 29522161) BMC Pregnancy Childbirth. 2016 Apr 27;16:93. (PMID: 27121857) J Health Econ. 2006 Jul;25(4):740-61. (PMID: 16356570) Health Serv Res. 2016 Aug;51(4):1546-60. (PMID: 26806952) Epidemiology. 2018 Jul;29(4):e31-e32. (PMID: 29570474) Health Serv Res. 2024 Apr;59(2):e14248. (PMID: 37840011) Health Serv Res. 2020 Apr;55(2):288-300. (PMID: 31989591) |
| معلومات مُعتمدة: | University of North Carolina at Charlotte, Belk College Summer Research |
| فهرسة مساهمة: | Keywords: health economics; hospitals; maternal and perinatal care and outcomes; obstetrics and gynecology; rural health |
| تواريخ الأحداث: | Date Created: 20231015 Date Completed: 20240307 Latest Revision: 20240308 |
| رمز التحديث: | 20240308 |
| مُعرف محوري في PubMed: | PMC10915477 |
| DOI: | 10.1111/1475-6773.14248 |
| PMID: | 37840011 |
| قاعدة البيانات: | MEDLINE |
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