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Evidence Brief: Effects of Small Hospital Closure on Patient Health Outcomes

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Evidence Brief: Effects of Small Hospital Closure on Patient Health Outcomes (June 2013)

Principal Investigator: Susan Carson, MPH
Contributing Investigators:
Kim Peterson, MS Linda Humphrey, MD, MPH Mark Helfand, MD, MPH, MS

Evidence-based Synthesis Program (ESP) Center
Portland VA Medical Center

Washington (DC): Department of Veterans Affairs; June 2013

Download PDF: Brief, Supplement


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 Questions

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, size, etc.)?

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