[An American in Clamency: closing of small hospitals in France].
This article chronicles events in 1993-1994 in the small rural town of Clamecy, located in the Burgundy region of France, stemming from proposals of regional planning authorities to close the maternity and emergency services of the local hospital. This possibility engendered a series of protests and maneuvers by town notables, hospital personnel, and local physicians to halt such plans. The situation provided an opportunity for a sociological examination of the role of the hospital in the social and economic life of a rural community. This included a series of unstructured interviews with various townspeople and health professionals conducted within a sociological framework and with the benefit of the author's status as a foreign observer, beholden to no particular French political affiliation or health policy position. The results of the study reveal profoundly held perceptions that the hospital was a key element in the social, cultural, and economic life of the community, far surpassing its "mere" role as a health delivery organization. These findings are placed in the French context of rural development on the one hand, and rationalization of the health delivery system on the other.
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School of Public Health, University of Michigan, Ann Arbor, USA.
D005602:France; D006285:Health Planning; D006754:Hospital Restructuring; D006780:Hospitals, Rural; D006801:Humans