Physician perspectives on the causes of rural hospital closure, 1980-1988.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Pirani
M J
MJ
Department of Family Medicine, WAMI Rural Health Research Center, University of Washington School of Medicine, Seattle.
Hart
L G
LG
Rosenblatt
R A
RA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D004465:Economic Competition; D005377:Financial Management, Hospital; D006075:Governing Board; D006271:Health Facility Closure; D006291:Health Policy; D006302:Health Services Research; D006764:Hospitals, Community; D006769:Hospitals, General; D006780:Hospitals, Rural; D006801:Humans; D007857:Leadership; D009111:Local Government; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D011787:Quality of Health Care; D012051:Reimbursement Mechanisms; D014481:United States