IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i12p7258-d838140.html
   My bibliography  Save this article

The Impact of Rural Hospital Closures and Health Service Restructuring on Provincial- and Community-Level Patterns of Hospital Admissions in New Brunswick

Author

Listed:
  • Dan L. Crouse

    (Department of Sociology, University of New Brunswick, Fredericton, NB E3B 5A3, Canada
    New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, NB E3B 5A3, Canada)

  • Kyle Rogers

    (New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, NB E3B 5A3, Canada)

  • Adele Balram

    (New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, NB E3B 5A3, Canada)

  • James T. McDonald

    (New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, NB E3B 5A3, Canada
    Department of Political Science, University of New Brunswick, Fredericton, NB E3B 5A3, Canada)

Abstract

In the early 2000s, the Province of New Brunswick, Canada, undertook health system restructuring, including closing some rural hospitals. We examined whether changes in geographic access to hospitals and primary care were associated with changes in patterns of hospital use. We described three measures of hospital use for ambulatory care sensitive conditions (ACSCs) among adults 75 years and younger annually during the period 2004–2013 overall, and at the community scale. We described spatial and temporal patterns in: age-standardized hospitalization rates, age-standardized incidence of hospital admissions, and rates of admissions via ambulance. Overall, rates and incidence of hospitalizations for ACSCs declined while admissions via ambulance remained largely unchanged. We observed considerable regional variation in rates between communities in 2004. This regional variation decreased over time, with rural areas demonstrating the sharpest declines. Changes in hospital service provision within individual communities had little impact on rates of ACSC admissions. Results were consistent across urban and rural communities and were robust to analyses that included older patients and those admitted for reasons other than ACSCs. Our results suggest that the restructuring and hospital closures did not result in substantial changes to regional patterns or rates of service use.

Suggested Citation

  • Dan L. Crouse & Kyle Rogers & Adele Balram & James T. McDonald, 2022. "The Impact of Rural Hospital Closures and Health Service Restructuring on Provincial- and Community-Level Patterns of Hospital Admissions in New Brunswick," IJERPH, MDPI, vol. 19(12), pages 1-13, June.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:12:p:7258-:d:838140
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/12/7258/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/19/12/7258/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Hanlon, Neil & Skedgel, Chris, 2006. "Cross-district utilization of general hospital care in Nova Scotia: Policy and service delivery implications for rural districts," Social Science & Medicine, Elsevier, vol. 62(1), pages 145-156, January.
    2. Laberge, Maude & Wodchis, Walter P. & Barnsley, Jan & Laporte, Audrey, 2017. "Hospitalizations for ambulatory care sensitive conditions across primary care models in Ontario, Canada," Social Science & Medicine, Elsevier, vol. 181(C), pages 24-33.
    3. James, Amanda M., 1999. "Closing rural hospitals in Saskatchewan: on the road to wellness?," Social Science & Medicine, Elsevier, vol. 49(8), pages 1021-1034, October.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. 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.
    2. Garcia-Lacalle, Javier & Martin, Emilio, 2010. "Rural vs urban hospital performance in a 'competitive' public health service," Social Science & Medicine, Elsevier, vol. 71(6), pages 1131-1140, September.
    3. Lauren E Wallar & Laura C Rosella, 2020. "Risk factors for avoidable hospitalizations in Canada using national linked data: A retrospective cohort study," PLOS ONE, Public Library of Science, vol. 15(3), pages 1-21, March.
    4. Elenka Brenna & Federico Spandonaro, 2014. "Does federalism induce patients’ mobility across regions? Evidence from the Italian experience," DISCE - Working Papers del Dipartimento di Economia e Finanza def009, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    5. Duminy, Lize & Ress, Vanessa & Wild, Eva-Maria, 2022. "Complex community health and social care interventions – Which features lead to reductions in hospitalizations for ambulatory care sensitive conditions? A systematic literature review," Health Policy, Elsevier, vol. 126(12), pages 1206-1225.
    6. Frankish, C. James & Kwan, Brenda & Ratner, Pamela A. & Higgins, Joan Wharf & Larsen, Craig, 2002. "Social and political factors influencing the functioning of regional health boards in British Columbia (Canada)," Health Policy, Elsevier, vol. 61(2), pages 125-151, August.
    7. Laberge, Maude & Gaudreault, Myriam, 2019. "Promoting access to family medicine in Québec, Canada: Analysis of bill 20, enacted in November 2015," Health Policy, Elsevier, vol. 123(10), pages 901-905.
    8. Thomas P. Weil, 2016. "What can the Canadians and Americans learn from each other's health care systems?," International Journal of Health Planning and Management, Wiley Blackwell, vol. 31(3), pages 349-370, July.
    9. Ting Chen & Jay Pan, 2022. "The Effect of Spatial Access to Primary Care on Potentially Avoidable Hospitalizations of the Elderly: Evidence from Chishui City, China," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 160(2), pages 645-665, April.
    10. Wilson, Kathi & Rosenberg, Mark W., 2004. "Accessibility and the Canadian health care system: squaring perceptions and realities," Health Policy, Elsevier, vol. 67(2), pages 137-148, February.
    11. Ona, Lucia Y., 2018. "The Effect of Rural Hospital Closure on the Health Status and Access to Care of the Aging Population in five states of the United States," 2018 Annual Meeting, August 5-7, Washington, D.C. 274493, Agricultural and Applied Economics Association.
    12. Eriksen, Astrid & Berger, Elke & Reichebner, Christoph & Wiedicke, Annemarie & Busse, Reinhard, 2023. "The media's coverage and framing of hospital reforms: The case of Denmark," Health Policy, Elsevier, vol. 133(C).
    13. Natalia Nunes Ferreira‐Batista & Adriano Dutra Teixeira & Maria Dolores Montoya Diaz & Fernando Antonio Slaibe Postali & Rodrigo Moreno‐Serra & James Love‐Koh, 2023. "Is primary health care worth it in the long run? Evidence from Brazil," Health Economics, John Wiley & Sons, Ltd., vol. 32(7), pages 1504-1524, July.
    14. Jason P. Holcomb & Paul Frederic & Stanley D. Brunn, 2020. "A Visual Typology of Abandonment in Rural America: From End-of-Life to Treading Water, Recycling, Renaissance, and Revival," Land, MDPI, vol. 9(3), pages 1-26, March.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:19:y:2022:i:12:p:7258-:d:838140. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.