Abstract
Social trends and the costs of health technologies lead to concentrate the availability of specialized services. This raises debates on the appropriate geography of healthcare. An example is the discussion about the rationality of closing small hospitals, typically located in rural and/or remote areas. We analyzed two cases of rural and/or remote areas of Switzerland experiencing a radical reorganization of a previously existing hospital.
Highlights
The financial crisis has raised pressures toward reforming the welfare systems of Western countries
An example is the discussion about the rationality of closing small hospitals, typically located in rural and/or remote areas
The combination of declining fertility and mortality rates, and the increase in life expectancy has meant that the populations are becoming weighted increasingly towards older age group in most European countries (Tinker, 2002; COM, 2006). This trend is projected to enlarge and deepen globally (Anderson and Hussey, 2000) – with the proportion of people aged 65 or over is expected to overcome the threshold of 26% in the European Union in 2040 (Giannakouris, 2008) – influencing dramatically the economic, social and political spheres (United Nations, 2001). This trend impacts on healthcare, because it is associated with a high prevalence of chronic diseases, and high risks of poly-morbidities and adverse outcomes (Anderson and Hussey, 2000; WHO, 2005)
Summary
The financial crisis has raised pressures toward reforming the welfare systems of Western countries. The combination of declining fertility and mortality rates, and the increase in life expectancy has meant that the populations are becoming weighted increasingly towards older age group in most European countries (Tinker, 2002; COM, 2006). This trend is projected to enlarge and deepen globally (Anderson and Hussey, 2000) – with the proportion of people aged 65 or over is expected to overcome the threshold of 26% in the European Union in 2040 (Giannakouris, 2008) – influencing dramatically the economic, social and political spheres (United Nations, 2001). We focused on the organizational and service delivery levels in this work
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