Effects of rural hospital closures on nurse staffing levels and health care utilization at nearby hospitals.

IF 2 3区医学 Q2 ECONOMICS

Health economics Pub Date : 2024-08-09 DOI:10.1002/hec.4889

Jing Dong, Siying Liu, Asefeh Faraz Covelli, Guido Cataife

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引用次数: 0

Abstract

Our study examines the causal effect of rural hospital closures on nearby hospitals' nurse staffing levels and health care utilization. We use data from the 2014-2019 American Hospital Association Survey on nurse staffing level outcomes including licensed practical or vocational nurses (LPNs), registered nurses (RNs), and advanced practice nurses (APNs); and health care utilization outcomes, including inpatient and outpatient surgical operations and emergency department (ED) visits. Using propensity score matching and difference-in-differences (DID) methods, we find that rural hospital closures lead to an average increase of 37.3% in the number of nurses in nearby rural hospitals during the 4 years following the closure. This increase is found across all categories of nurses, including LPNs, RNs, and APNs. We also find a substantial increase in the provision of inpatient and outpatient surgical operations but there is no change in ED visits. We do not find any effects for nearby urban hospitals. Our study suggests that a large proportion of the nursing workforce relocates to nearby hospitals after a rural hospital closure, which mitigates the negative consequences of such closures and allows these nearby hospitals to provide a larger volume of highly profitable services.

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农村医院关闭对附近医院护士配备水平和医疗服务利用率的影响。

我们的研究探讨了乡村医院关闭对附近医院护士人员配备水平和医疗服务利用率的因果影响。我们使用的数据来自 2014-2019 年美国医院协会调查，内容涉及护士人员配备水平结果，包括执业或职业护士 (LPN)、注册护士 (RN) 和高级执业护士 (APN)；以及医疗保健利用率结果，包括住院和门诊手术以及急诊科 (ED) 就诊。利用倾向得分匹配和差分法（DID），我们发现乡镇医院关闭会导致附近乡镇医院的护士人数在医院关闭后的 4 年内平均增加 37.3%。这一增长体现在所有类别的护士中，包括初级护士、护士和助理护士。我们还发现，住院病人和门诊病人的外科手术量大幅增加，但急诊室就诊人数没有变化。我们没有发现附近城市医院受到任何影响。我们的研究表明，农村医院关闭后，很大一部分护理人员会迁移到附近的医院，从而减轻了医院关闭带来的负面影响，并使这些附近的医院能够提供更多的高利润服务。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health economics 医学-卫生保健

CiteScore

3.60

自引率

4.80%

发文量

177

审稿时长

4-8 weeks

期刊介绍： This Journal publishes articles on all aspects of health economics: theoretical contributions, empirical studies and analyses of health policy from the economic perspective. Its scope includes the determinants of health and its definition and valuation, as well as the demand for and supply of health care; planning and market mechanisms; micro-economic evaluation of individual procedures and treatments; and evaluation of the performance of health care systems. Contributions should typically be original and innovative. As a rule, the Journal does not include routine applications of cost-effectiveness analysis, discrete choice experiments and costing analyses. Editorials are regular features, these should be concise and topical. Occasionally commissioned reviews are published and special issues bring together contributions on a single topic. Health Economics Letters facilitate rapid exchange of views on topical issues. Contributions related to problems in both developed and developing countries are welcome.