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Impact of rural hospital closures in Saskatchewan, Canada


  • Liu, Liyan
  • Hader, Joanne
  • Brossart, Bonnie
  • White, Robin
  • Lewis, Steven


Canada's health care system has undergone major changes since 1990. In Saskatchewan, 52 small rural hospitals funded for less than eight beds stopped receiving funding for acute care services in 1993. Most were subsequently converted to primary health care centers. Since then, concerns have been raised about the impact of the changes on rural residents' access to care, their health status, and the viability of rural communities. To assess the impact of hospital closures on the affected communities, we conducted a multi-faceted, province-wide study. We looked at hospital use patterns, health status, rural residents' perceptions of the impact of these hospital closures, and how communities responded to the changes. We found the hospital closures did not adversely affect rural residents' health status or their access to inpatient hospital services. Despite widespread fears that health status would decline, residents in these communities reported that hospital closures did not adversely affect their own health. Although some communities continue to struggle with changes to health care delivery, others appear to have adapted as a result of strong community leadership, the development of widely accepted alternative services, and local support for creating innovative solutions. Good rural health care does not depend on the presence of a very small hospital that cannot, in today's environment, provide genuinely acute care. It requires creative approaches to the provision of primary care, good emergency services, and good communication with the public on the intent and outcomes of change.

Suggested Citation

  • Liu, Liyan & Hader, Joanne & Brossart, Bonnie & White, Robin & Lewis, Steven, 2001. "Impact of rural hospital closures in Saskatchewan, Canada," Social Science & Medicine, Elsevier, vol. 52(12), pages 1793-1804, June.
  • Handle: RePEc:eee:socmed:v:52:y:2001:i:12:p:1793-1804

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    References listed on IDEAS

    1. Deininger, Klaus & Squire, Lyn, 1996. "A New Data Set Measuring Income Inequality," World Bank Economic Review, World Bank Group, vol. 10(3), pages 565-591, September.
    2. Ettner, Susan L., 1996. "New evidence on the relationship between income and health," Journal of Health Economics, Elsevier, vol. 15(1), pages 67-85, February.
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    Cited by:

    1. Avdic, Daniel, 2016. "Improving efficiency or impairing access? Health care consolidation and quality of care: Evidence from emergency hospital closures in Sweden," Journal of Health Economics, Elsevier, vol. 48(C), pages 44-60.
    2. Heather Conde & James Ted McDonald, 2007. "The Health Services Use Among Older Canadians in Rural and Urban Areas," Social and Economic Dimensions of an Aging Population Research Papers 178, McMaster University.
    3. Avdic, Danie, 2015. "A matter of life and death? Hospital distance and quality of care: evidence from emergency hospital closures and myocardial infarctions," Working Paper Series 2015:1, IFAU - Institute for Evaluation of Labour Market and Education Policy.
    4. Panelli, Ruth & Gallagher, Lou & Kearns, Robin, 2006. "Access to rural health services: Research as community action and policy critique," Social Science & Medicine, Elsevier, vol. 62(5), pages 1103-1114, March.
    5. Ahgren, Bengt, 2008. "Is it better to be big?: The reconfiguration of 21st century hospitals: Responses to a hospital merger in Sweden," Health Policy, Elsevier, vol. 87(1), pages 92-99, July.
    6. repec:eee:socmed:v:182:y:2017:i:c:p:60-67 is not listed on IDEAS


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