The objective of this evidence brief is to synthesize the literature on the effects of closing
an existing small hospital on patient health outcomes. An evidence brief differs from a full
systematic review in that the scope of work is more narrowly defined and the traditional review
methods are streamlined in order to synthesize evidence within a shortened timeframe.
The ESP Coordinating Center investigators and representatives of the Health Delivery
Committee Workgroup worked together to identify the population, intervention, comparators,
timing, setting and study design characteristics of interest. The Health Delivery Committee
Workgroup approved the following key questions and eligibility criteria to guide this review:
Key Question 1. What is the impact of closing small hospitals (number of beds < 100,
average daily census .60) on patient health outcomes?
Key Question 2. How does the impact of small hospital closures vary based on patient
characteristics (e.g., age, race/ethnicity, socioeconomic status, health conditions, etc.),
geographical location, and the characteristics of the nearest facilities (e.g., distance,