Impact of rural hospital closures in Saskatchewan, Canada

Liu, Liyan; Hader, Joanne; Brossart, Bonnie; White, Robert L.; Lewis, Stephen

doi:10.1016/s0277-9536(00)00298-7

Cited by 58 publications

(61 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…After a large increase in costs in the incident year, costs were relatively stable, despite increases in prescription, day surgery, and dialysis costs. Decreased hospital costs over the study period, which offset cost increases in the other categories, may reflect changes in hospitalization rates, length of stay, case mix, and service intensity (12,16,17). It is also possible that decreased hospital costs in the later years of follow-up reflect a survival bias in which healthier individuals survived to the end of the follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Health Care Use and Costs in the Decade After Identification of Type 1 and Type 2 Diabetes

2006

View full text Add to dashboard Cite

OBJECTIVE -To analyze trends in health care costs in the decade after identification of diabetes, contrasting type 1 and 2 diabetes.RESEARCH DESIGN AND METHODS -The Canadian National Diabetes Surveillance System criteria were applied to administrative databases to identify incident diabetes cases in 1992. Cases were categorized as type 1 or type 2 diabetes based on patterns of drug use. Per capita health care costs (in 2001 Canadian dollars) for five resource categories were estimated according to the type of diabetes, for the year before identification (1991) and 10 years after (1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001) identification of the cases.RESULTS -We identified 156 type 1 and 3,469 type 2 incident cases of diabetes, from a population base of ϳ950,000. The mean (ϮSD) age of case subjects at index was 61.2 Ϯ 16.7 years, and 54% of subjects were male. Overall annual per capita health expenditures rose considerably in the year after identification of diabetes but then stabilized at a lower level for the next 9 years, ranging from $3,800 to $4,400. From 1992 to 2001, diabetic individuals used $137.1 million in health care resources, most of which (96%) was attributable to type 2 diabetes. The average 10-year cost per individual with diabetes was $37,820 ($33,684 per type 1 and $38,006 per type 2 diabetes case; adjusted P ϭ 0.45).CONCLUSIONS -Total health expenditures for diabetes are driven by the much larger prevalence of type 2 compared with type 1 diabetes. Policymakers need to acknowledge and allocate resources for diabetes prevention and management accordingly.

show abstract

Section: Discussionmentioning

confidence: 99%

Health Care Use and Costs in the Decade After Identification of Type 1 and Type 2 Diabetes

2006

View full text Add to dashboard Cite

show abstract

“…26 However, other studies have found limited effects of closures on outcomes. 27 The main objective of this study is to assess the hospital characteristics that influence rural residents' decisions to use rural hospitals rather than bypass them to obtain inpatient care in urban areas. Based on the literature we reviewed, a particular focus of the study is whether patients' tendency to bypass rural hospitals is explained by the limited services and technologies many of them offer.…”

Section: 11mentioning

confidence: 99%

Do Patients Bypass Rural Hospitals?: Determinants of Inpatient Hospital Choice in Rural California

Escarce¹,

Kapur²

2009

hpu

View full text Add to dashboard Cite

Rural hospitals play a crucial role in providing health care to rural Americans, a vulnerable and underserved population; however, rural hospitals have faced threats to their financial viability and many have closed as a result. This paper examines the hospital characteristics that are associated with patients choosing rural hospitals, and sheds light on the types of patients who depend on rural hospitals for care and, hence, may be the most harmed by the closure of rural hospitals. Using data from California hospitals, the paper shows that patients were more likely to choose nearby hospitals, larger hospitals, and hospitals that offered more services and technologies. However, even after adjusting for these factors, patients had a propensity to bypass rural hospitals in favor of large urban hospitals. Offering additional services and technologies would increase the share of rural residents choosing rural hospitals only slightly.

show abstract

“…These changes have been more pronounced with public sector services in recent years as provincial and federal governments in Canada have regionalized their services. Service restructuring may mean that citizens must travel to other places to access services, and this can be particularly difficult for residents who do not have access to transportation (Carter 1990;Liu et al 2001;Robinson 1990). If residents of rural and small town places wish to retain these services, they will have to find new ways to have them delivered.…”

Section: Introductionmentioning

confidence: 99%

The Deployment of Partnerships by the Voluntary Sector to Address Service Needs in Rural and Small Town Canada

Halseth

Ryser

2007

Voluntas

View full text Add to dashboard Cite

Service restructuring trends since the 1980s have resulted in the downsizing or closure of many services in rural and small town Canada. In response, voluntary groups have been filling some of the emerging service gaps. Services, however, often are directed at complex problems that demand information, support, or assistance from a range of sources and institutions. For voluntary groups, this underscores a need to partner with other groups, organizations, or service providers. At the same time, voluntary organizations are increasingly encouraged to develop partnerships with public or private partners in order to qualify for government funding. This study tracks 29 voluntary organizations in four rural and small town places across Canada to explore the development and maintenance of partnerships (both local and non-local), as well as the types of networks, resources, and expertise for which partnerships were used. The findings indicate that while voluntary organizations feel that local partnerships are more important, partnerships with groups outside of these places are equally developed. Partnerships were used to expand networks, obtain expertise, and access a range of resources to assist in daily operations and delivery of services. The increase in partnerships with groups outside of these communities, particularly with non-local service providers, will have important implications for voluntary organizations and policy makers.

show abstract

Impact of rural hospital closures in Saskatchewan, Canada

Cited by 58 publications

References 9 publications

Health Care Use and Costs in the Decade After Identification of Type 1 and Type 2 Diabetes

Health Care Use and Costs in the Decade After Identification of Type 1 and Type 2 Diabetes

Do Patients Bypass Rural Hospitals?: Determinants of Inpatient Hospital Choice in Rural California

The Deployment of Partnerships by the Voluntary Sector to Address Service Needs in Rural and Small Town Canada

Contact Info

Product

Resources

About