Hospitals in rural or remote areas: An exploratory review of policies in 8 high-income countries.
Our study reviewed policies in 8 high-income countries (Australia, Canada, United States, Italy, Spain, United Kingdom, Croatia and Estonia) in Europe, Australasia and North America with regard to hospitals in rural or remote areas. We explored whether any specific policies on hospitals in rural or remote areas are in place, and, if not, how countries made sure that the population in remote or rural areas has access to acute inpatient services. We found that only one of the eight countries (Italy) had drawn up a national policy on hospitals in rural or remote areas. In the United States, although there is no singular comprehensive national plan or vision, federal levers have been used to promote access in rural or remote areas and provide context for state and local policy decisions. In Australia and Canada, intermittent policies have been developed at the sub-national level of states and provinces respectively. In those countries where access to hospital services in rural or remote areas is a concern, common challenges can be identified, including the financial sustainability of services, the importance of medical education and telemedicine and the provision of quick transport to more specialized services.
European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H9SH, United Kingdom. Electronic address: Bernd.Rechel@lshtm.ac.uk.
Bernd
B
Rechel
Andrija Štampar School of Public Health, Zagreb, Croatia. Electronic address: adzakula.snz@gmail.com.
Aleksandar
A
Džakula
Alldmhealth Consulting, Sevilla, Spain. Electronic address: aduran@alldmh.com.
Antonio
A
Duran
Bocconi University, Italy. Electronic address: giovanni.fattore@unibocconi.it.
Giovanni
G
Fattore
Nuffield Trust, London, United Kingdom. Electronic address: nigel.edwards@nuffieldtrust.org.uk.
Nigel
N
Edwards
McMaster University, Hamilton, Ontario, Canada. Electronic address: grignon@mcmaster.ca.
Michel
M
Grignon
University of Technology, Sydney, Australia. Electronic address: Marion.Haas@chere.uts.edu.au.
Marion
M
Haas
Ministry of Social Affairs, Estonia. Electronic address: triinhab@gmail.com.
Triin
T
Habicht
University of Toronto, Toronto, Ontario, Canada. Electronic address: greg.marchildon@utoronto.ca.
Gregory P
GP
Marchildon
Alldmhealth Consulting, Sevilla, Spain. Electronic address: amoreno@alldmh.com.
Antonio
A
Moreno
Catholic University of the Sacred Heart, Rome, Italy. Electronic address: wricciardi@rm.unicatt.it.
Walter
W
Ricciardi
Nuffield Trust, London, United Kingdom. Electronic address: louella.vaughan@nuffieldtrust.org.uk.
Louella
L
Vaughan
Anderson Smith Consulting, LLC, United States. Electronic address: tsmith.ghpc@gmail.com.
Tina Anderson
TA
Smith
D019049:Developed Countries; D004501:Education, Medical; D014943:Global Health; D006297:Health Services Accessibility / Q000458:organization & administration*; D006761:Hospitals; D006801:Humans; D008507:Medically Underserved Area; D019035:Rural Health Services / Q000458:organization & administration*; D012424:Rural Population / Q000706:statistics & numerical data; D017216:Telemedicine / Q000706:statistics & numerical data; D000078329:Workforce
Emergencies; Hospitals; Rural health services; Rural hospitals