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The Impact of Rural Hospital Closures and Health Service Restructuring on Provincial- and Community-Level Patterns of Hospital Admissions in New Brunswick

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  • Dan L. Crouse

    (Department of Sociology, University of New Brunswick, Fredericton, NB E3B 5A3, Canada
    New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, NB E3B 5A3, Canada)

  • Kyle Rogers

    (New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, NB E3B 5A3, Canada)

  • Adele Balram

    (New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, NB E3B 5A3, Canada)

  • James T. McDonald

    (New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, NB E3B 5A3, Canada
    Department of Political Science, University of New Brunswick, Fredericton, NB E3B 5A3, Canada)

Abstract

In the early 2000s, the Province of New Brunswick, Canada, undertook health system restructuring, including closing some rural hospitals. We examined whether changes in geographic access to hospitals and primary care were associated with changes in patterns of hospital use. We described three measures of hospital use for ambulatory care sensitive conditions (ACSCs) among adults 75 years and younger annually during the period 2004–2013 overall, and at the community scale. We described spatial and temporal patterns in: age-standardized hospitalization rates, age-standardized incidence of hospital admissions, and rates of admissions via ambulance. Overall, rates and incidence of hospitalizations for ACSCs declined while admissions via ambulance remained largely unchanged. We observed considerable regional variation in rates between communities in 2004. This regional variation decreased over time, with rural areas demonstrating the sharpest declines. Changes in hospital service provision within individual communities had little impact on rates of ACSC admissions. Results were consistent across urban and rural communities and were robust to analyses that included older patients and those admitted for reasons other than ACSCs. Our results suggest that the restructuring and hospital closures did not result in substantial changes to regional patterns or rates of service use.

Suggested Citation

  • Dan L. Crouse & Kyle Rogers & Adele Balram & James T. McDonald, 2022. "The Impact of Rural Hospital Closures and Health Service Restructuring on Provincial- and Community-Level Patterns of Hospital Admissions in New Brunswick," IJERPH, MDPI, vol. 19(12), pages 1-13, June.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:12:p:7258-:d:838140
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    References listed on IDEAS

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    1. Hanlon, Neil & Skedgel, Chris, 2006. "Cross-district utilization of general hospital care in Nova Scotia: Policy and service delivery implications for rural districts," Social Science & Medicine, Elsevier, vol. 62(1), pages 145-156, January.
    2. Laberge, Maude & Wodchis, Walter P. & Barnsley, Jan & Laporte, Audrey, 2017. "Hospitalizations for ambulatory care sensitive conditions across primary care models in Ontario, Canada," Social Science & Medicine, Elsevier, vol. 181(C), pages 24-33.
    3. James, Amanda M., 1999. "Closing rural hospitals in Saskatchewan: on the road to wellness?," Social Science & Medicine, Elsevier, vol. 49(8), pages 1021-1034, October.
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