Factors Associated with the Closure of Small Hospitals, Clinics, and Dental Clinics

This study assayed regional distribution of dental hospital & dental clinics, the number of population & households per one dental hospital & clinic, operation condition & duration. This study used public data that display from 1946 years(the first dental clinic open in republic of korea) to 2016 years. We collected present condition of 21,686 dental hospital and clinics available in public data portal site on 28. Feb.2016. Data were classified by scale, location, permission year, operation duration of dental hospital & clinics and were analyzed using SPSS 20.0 program. Surveyed on Feb. 2016. Best top 10 regions of permission dental clinics are (1) Gangnam-gu, Seoul(1,337), (2) Seongnamsi, Gyeonggi-do(555), (3) Songpa-gu, Seoul(491), (4) Yeongdeungpo-gu, Seoul(472), (5) Suwon-si, Gyeonggi-do(443), (6) Seocho-gu, Seoul(428), (7) Nowon-gu, Seoul(417), (8) Goyang-si, Gyeonggi-do(413), (9) Jung-gu, Seoul(380), (10) Yongin-si, Gyeonggi-do(353). Whereas best top 10 regions of operating dental clinics are (1) Gangnam-gu, Seoul(581), (2) Seongnamsi, Gyeonggi-do(415), (3) Suwon-si, Gyeonggi-do(382), (4) Seocho-gu, Seoul(320), (5) Changwon-si, Gyeongsangnam-do(303), (6) Songpa-gu, Seoul(295) (7) Goyang-si, Gyeonggi-do(290), (8) Bucheon-si and Yongin-si, Gyeonggi-do(262), (9) Jeonju-si, Jeollabuk-do(224). Average population per one dental hospital & clinic by regional local government are 3,120 people. Best five region of population per one dental hospital & clinic are (1) Sejong-si(5,272), (2) Gangwon-do(4,653), (3) Chungcheongbuk-do(4,513), (4) Gyeongsangbuk-do(4,490), (5) Chungcheongnam-do(4,402). Average households per one dental hospital & clinic by regional local government are 1,316 households. Best three region of households per one dental hospital & clinic are (1) Sejong-si(2,126), (2) Gangwon-do(2,057), (3) Gyeongsangbuk-do(1,946). From 1946 to 1986, permission and operating dental hospital and clinics was steadily increasing. On 1986-1990, 1991-1995, permission, operation and closure of dental hospital and clinics increase rapidly. From the 2011-2015 to 2016(present), permission, operation and closure of dental hospital and clinics is decreasing. Average operating duration of closured dental hospital and clinics are 14.054 years. We need to map of dental hospital and clinics for open and operation of one, base on analyzed results. In an era of 30,000 dentist, we should to be concerned about operation of dental clinics in the light of past operating condition.

Impact of rural hospital closures in Saskatchewan, Canada

We conducted a survey to investigate the status regarding the implementation of oral health care for inpatients aged 65 years and older who were in the acute stages of stroke and to examine the factors related to the details of excellent model hospitals. We sent a questionnaire on oral health care targeting all 8089 hospitals in Japan. On the basis of the responses obtained from the hospitals, we conducted a survey to analyze the factors defining what are known to be excellent model hospitals. We then conducted a logistic regression analysis using a stepwise procedure. Replies were received from 2444 of the 8089 hospitals (30.2%): 91.8% of the hospitals reported that oral health care was a part of the daily nursing routine while 91.2% of the hospitals considered that aspiration pneumonia could be prevented by appropriate oral health care. Only 30% of the nurses had undergone oral hygiene training. Among the factors involved in excellent model hospitals, we observed a strong correlation with a sense of the necessity for oral health care, oral hygiene training for nurses and a large number of hospital beds. Large scale hospitals tend to be more interested in oral health care than smaller hospitals. Providing oral health care is already common in acute hospitals in Japan. There is a great demand for oral hygiene training and obtaining information from dental professionals. It is important to promote the cooperation between dental and nursing personnel within hospitals regarding oral hygiene training.

The coronavirus pandemic (COVID-19) has affected the delivery of healthcare services and posed enormous challenges to medical and dental care across the world. This article sought to explore various challenges implicated in the provision, access, and utilization of oral healthcare services in Sudan and to describe the current situation amid COVID-19. The oral health sector in Sudan has been experiencing multiple challenges in the delivery of dental care, and the current pandemic of COVID-19 has aggravated and multiplied the existing challenges. Conflict, economic meltdown, and political instability have disrupted all medical and dental services in many parts of Sudan. Furthermore, the oral health sector in Sudan suffers a lack of essential instruments, materials, and supplies, a shortage of health workers, and poor infection control practices, which present major threats to dental care in the region. The COVID-19 pandemic has contributed to further scarcity of essential materials and supplies. Moreover, the frequent closure of dental hospitals and clinics either due to civil disobedience or COVID-19 lockdown has limited accessibility and utilization of oral services. There is an urgent need to address challenges identified to ensure adequate provision of oral healthcare in Sudan.

Mayors of rural towns whose small general hospitals closed between 1980 and 1988 were surveyed. Only hospitals that were the sole hospitals in their towns and that had not reopened were included in the survey. Of the 132 hospitals meeting these criteria, 130 (98.5%) of the mayors of their communities responded to the survey. The typical study hospital had 31 beds, with an average daily census of 12. Three fourths of the hospital closures were in the North-Central and South census regions. Half of the hospital closures were for hospitals that were 20 miles or more from another hospital. Mayors attributed the closure of their hospitals primarily to governmental reimbursement policies, poor hospital management and lack of physicians. To a lesser extent, they also implicated competition from other hospitals, reputation for poor quality care, lack of provider teamwork, and inadequate hospital board leadership. Respondents reported they had little warning that their hospitals were in imminent danger of closing. Warnings of six months or less were reported by 49 percent of the mayors; only 33 percent of mayors of towns with for-profit hospitals reported having more than six months warning. Of the 132 hospital buildings that closed, only 38 percent were not in use in some capacity in the summer of 1989. Most were being utilized as some form of health care facility such as an ambulatory clinic, nursing home, or emergency room. More than three fourths of the mayors felt access to medical care had deteriorated in their communities after hospital closure, with a disproportionate impact on the elderly and poor. Nearly three fourths of the mayors also perceived that the health status of the community was worse because of the hospital closure, and more than 90 percent felt it had substantially impaired the community's economy.

ObjectivesThe objective of this study was to investigate the factors associated with website operation among medical facilities.MethodsA cross-sectional study design was employed to investigate 1,519 hospitals, 33,043 medical clinics (MCs), and 18,240 dental clinics (DCs) as of 2020. The main outcome variable was analyzed according to technological, organizational, and environmental factors.ResultsThe percentages of small hospitals, MCs, and DCs with websites were 26.4%, 9.0%, and 6.6%, respectively. For small hospitals, the nearby presence of a subway station (odds ratio [OR] = 2.772; 95% confidence interval [CI], 1.973–3.892; p < 0.0001) was the only factor significantly associated with website operation status. Among medical and dental clinics, the percentage of specialists—MCs (OR = 1.002; 95% CI, 1.000–1.004; p = 0.0175) and DCs (OR = 1.002; 95% CI, 1.001–1.004; p = 0.0061), the nearby presence of a subway station—MCs (OR = 2.954; 95% CI, 2.613–3.339; p < 0.0001) and DCs (OR = 3.444; 95% CI, 2.945–4.028; p < 0.0001), and the number of clinics in the local area—MCs (OR = 1.029; 95% CI, 1.026–1.031; p < 0.0001) and DCs (OR = 1.080; 95% CI, 1.066–1.093; p < 0.0001)—were significantly associated with website operation.ConclusionsClinics are critically affected by internal and external factors regarding website operation relative to small hospitals. Healthcare policymakers involved with information technologies may need to pay attention to those factors associated with website dispersion among small clinics.

Few studies seeking to determine the causes of rural hospital closure have examined the opinions of individuals intimately involved with the closed facilities. The purpose of this research was to examine the reasons for small sole community general hospital closures from the perspective of local physicians and to compare these reasons with the perceptions of local mayors. Hospitals in this study were selected from a list provided by the American Hospital Association. A two-page questionnaire was sent to every physician who had practiced in the towns in which a sole community general hospital had closed between 1980 and 1988. Physicians reported government reimbursement policies as the most important reasons for hospital closure, agreeing with the mayors' opinions. Other reasons cited were general financial difficulties, competition from other hospitals, and bad board leadership. More than three-quarters of the physicians surveyed considered the quality of care provided by their facilities to be average or better. The closure of rural hospitals that physicians consider of average or better quality suggests that many of the closed hospitals could have continued to provide valuable services to the residents of their communities. Efforts must be made to ensure that rural communities are not losing viable and useful facilities.

Hospital closures occur from time to time. These closures affect not only the patients that depend on the hospitals but also the economy in many rural areas. Many factors come into play when a hospital decides to shut off services. Although influencing reasons may vary, hospital closures are likely to be caused by financial shortfalls. In the USA recently, several rural hospitals have closed and many are on the verge of closing. The recent changes in the healthcare industry due to the new reforms are believed to have impacted certain small community and rural hospitals by putting them at risk of closure. In this article, we will discuss some of the highlights of the healthcare reforms and the events that followed, to relate how they may have affected the hospitals. We will also discuss what the future of these hospitals may look like and the necessary steps that the hospitals need to adopt to sustain themselves.

The number of hospital closures increased substantially after the implementation of Medicare's Prospective Payment System (PPS). This acceleration in closures raised a number of concerns over current payment policies and their impact on access. This paper investigates hospital closures that occurred in 1985 through 1988. A hospital's financial status and mission or community standing were found to be determinants of hospital closure. Closed hospitals are much less likely to be publicly owned but more likely to offer fewer facilities and services, and have fewer cases. This may suggest that the patients directly affected by the closure can be absorbed by other hospitals or other nonhospital providers. Profitability is associated with the Medicare case-mix index and the share of Medicare patients. The findings also suggest that the case mix index may be rewarding some small hospitals in excess of the costs attributable to case-mix. For both urban and rural hospitals, a low share of Medicare patients increased the risk of hospital closure, independently of the relationship between Medicare share and profit. The share of Medicare patients also affected closure indirectly, through its effects on profit. Competition appears to affect the odds of closure through its effects on the number of cases. In addition, hospitals in areas with small or declining population are more at risk than other hospitals in both urban and rural areas.

Rural hospital closures are high on the current healthcare agenda in Denmark. One concern raised is that rural hospital closures may further decrease population numbers in rural areas, as closures may induce some residents to move away from affected areas, i.e. closer to healthcare services elsewhere. The aim of this study was to investigate whether rural hospital closures may lead to out-migration in a Danish setting and to investigate which socioeconomic groups would be most likely to migrate. The island of AErø was selected as the case study area. The island has one small hospital. By the use of fully structured telephone interviews, a representative sample of AErø inhabitants (N=1000) was asked how important it was for them to live close to a hospital and whether they would consider moving away if their hospital was closed. Forty-seven per cent found it very important to live close to a hospital, and 29% would consider moving away if their hospital was closed. Multiple regression analyses showed that families with children were most likely to consider moving away and elderly people were least likely to consider moving away. The study suggests that rural hospital closures may lead to out-migration, although the hypothetical method of questioning leaves uncertainty about the actual scale of out-migration. Families with children appear to be the most likely out-migrants. Elderly people may be hardest hit by a hospital closure, being most reliant on healthcare and least inclined to move away.

Health policy in most West European countries is directed at transforming the healthcare systems into more self-regulating and competitive systems. After a period of strong regulation, the Dutch government decided to step back and created conditions in which competition could lead to cost management and quality improvement. The question is whether mergers have contributed to the survival chances of hospitals. This paper describes the results of an analysis performed on the survival of all Dutch hospitals in the years 1978 to 2010. The survival of hospitals during this period was determined and their survival rates were calculated statistically. Furthermore, the relation between a hospital's lifespan and a number of predictive variables was investigated. In this study, more detailed consideration is given to the fact of whether a hospital merged with another hospital. Bivariate analysis shows that smaller hospitals in particular have been driven out of the market. The difference in lifespan between hospitals which had merged and those which had not, appeared to be significant. However, a multivariate analysis, when corrected for size, type, and location, showed that merging had no significant effect on hospital lifespan.

Closing rural hospitals in Saskatchewan: on the road to wellness?

In March of 1991, Greg Martin, CEO of Grant Memorial, a small community hospital located in the southern portion of the United States, was pondering the effects of an all too frequent scenario. The hospital had once again seen a patient transfer to a nearby competitor’s hospital to have a surgery performed. The previous week a man had been brought in by ambulance to Grant, the closest hospital. After the doctors saved the man’s life, he was told that he needed immediate heart by-pass surgery. However, the patient requested to be transferred to a nearby competitor’s hospital to have the surgery performed. The next day, the man was transferred and the by-pass was successfully performed.

Severe Impact of Covid-19 Pandemic on Breast Cancer Care in Italy: A Senonetwork National Survey

The population ecology literature argues that at the macro level, organizations experience various liabilities to their continued survival. This study examined the effect of size, age, and niche density on the closure of acute care hospitals in Florida between 1965 and 1999. The primary data for the study was created using information about Florida hospitals found in the annual reports of the American Hospital Association (n = 427). Using the technique of survival analysis, it was found that newer hospitals and hospitals originally established in organizationally dense areas (five or more hospitals within a five mile radius) experienced a significantly greater incidence of closure than did those which were older or founded in less dense areas. Small hospitals (&lt;100 beds) were also shown to be significantly more likely to close than large ones (&gt;300 beds), as were hospitals located in organizationally sparse areas (no other hospitals in 5 mile radius) compared to those in organizationally dense areas (&gt;5 hospitals in 5 mile radius). The study concludes with an examination of the policy and management implications of the results.