Patient perspectives of the impact of a rural health center closure: A cross-sectional survey

Abstract

Purpose

To describe the impact from the closure of a rural community's only health center on chronic health conditions, access to care, and quality of care received from the patient's perspective.

Methods

This was a cross-sectional telephone survey. Adult patients established with a rural health center participated in a 19-item survey at 6 months post-closure to collect data on perceived impacts. Data were summarized using descriptive statistics.

Findings

There were 249 patients contacted, with 131 participants (52.6% response rate). Participants had a median age of 63 years (interquartile range, 44.5–73.0), and the majority were female (n = 82; 62.6%) and had been established with the health center for over 10 years (n = 79; 60.3%). At 6 months, the majority of participants had established care with another health center (n = 91; 69.5%). Most participants felt that the closure made it more difficult to access care (n = 106; 80.9%) but did not feel the closure reduced the quality of care they were receiving (n = 42; 32.1%). There was no impact perceived on the management of most health conditions, except chronic pain where worsening was the most selected option.

Conclusions

Patients were able to successfully transition care after closure of their local health center, and most did not perceive an impact on the quality of care received. However, participants reported reduced access to care. Future research might repeat this process, perhaps using a mixed-method approach, to intentionally capture nuances in patient behavior, experiences, and attitudes following the loss of primary care services in rural communities.