The problems of smaller, rural and remote hospitals: Separating facts from fiction

Vaughan, Louella; Edwards, Nigel

doi:10.7861/fhj.2019-0066

Cited by 34 publications

(27 citation statements)

References 58 publications

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“…(3) Health inequity is a major problem in many countries. Health resource maldistribution is of particular concern, with governments over the last decade backing centralization, and either merging or closing services in Australia, the United States, Canada, Germany, and France [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

The HINTS examination and STANDING algorithm in acute vestibular syndrome: A systematic review and meta-analysis involving frontline point-of-care emergency physicians

Nakatsuka

Molloy

2022

PLoS ONE

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This systematic review aims to evaluate whether point-of-care emergency physicians, without special equipment, can perform the HINTS examination or STANDING algorithm to differentiate between central and non-central vertigo in acute vestibular syndrome with diagnostic accuracy and reliability comparable to more specialized physicians (neuro-ophthalmologists and neuro-otologists). Previous research has concluded that emergency physicians are unable to utilize the HINTS examination with sufficient accuracy, without providing any appropriate education or training. A comprehensive systematic search was performed using MEDLINE, Embase, the Cochrane CENTRAL register of controlled trials, Web of Science Core Collection, Scopus, Google Scholar, the World Health Organization International Clinical Trials Registry Platform, and conference programs and abstracts from six medical organizations. Of the 1,757 results, only 21 were eligible for full-text screening. Two further studies were identified by a manual search of references and an electronic search for any missed studies associated with the authors. Five studies were included in the qualitative synthesis. For the STANDING algorithm, there were two studies of 450 patients who were examined by 11 emergency physicians. Our meta-analysis showed that emergency physicians who had received prior education and training were able to utilize the STANDING algorithm with a sensitivity of 0.96 (95% confidence interval: 0.87–1.00) and a specificity of 0.88 (0.85–0.91). No data was available for the HINTS examination. When emergency physicians are educated and trained, they can use the STANDING algorithm with confidence. There is a lack of evidence regarding the HINTS examination; however, two ongoing studies seek to remedy this deficit.

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Section: Discussionmentioning

confidence: 99%

The HINTS examination and STANDING algorithm in acute vestibular syndrome: A systematic review and meta-analysis involving frontline point-of-care emergency physicians

Nakatsuka

Molloy

2022

PLoS ONE

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“…It is reassuring that there is a continuous trend to focus on improving rural health around the world 39. However, further improvement should be made to ensure optimum use of limited resource by modifying rural health service models according to the local community needs 40…”

Section: Discussionmentioning

confidence: 99%

Beyond patient care: a qualitative study of rural hospitals’ role in improving community health

et al. 2022

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ObjectivesRural population face more health disadvantages than those living in urban and suburban areas. In rural communities, hospitals are frequently the primary organisation with the resources and capabilities to address health issues. This characteristic highlights their potential to be a partner and leader for community health initiatives. This study aims to understand rural hospitals’ motivations to engage in community health improvement efforts and examine their strategies to address community health issues.DesignEleven semistructured interviews were conducted with key leaders from four rural hospitals in a US Midwestern state. On-site and telephone interviews were audio-recorded and transcribed. The combination of inductive and deductive qualitative analysis was applied to identify common themes and categories.SettingsParticipating hospitals are located in US rural counties that have demonstrated progress in creating healthier communities.ResultsThree types of motivation drive rural hospitals’ community health improvement efforts: internal values, economic conditions and social responsibilities. Three categories of strategies to address community health issues were identified: building capacity, building relationships and building programmes.ConclusionsDespite the challenges, rural hospitals can successfully conduct community-oriented programmes. The finds extend the literature on how rural hospitals may strategise to improve rural health by engaging their communities and conduct activities beyond patient care.

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“…Besides, as stated above, despite having focused this research on the Spanish healthcare system, the identified success factors may be useful in other countries with a similar organisation and financing model of health system. Additionally, working with an evidence-based approach, along with experts’ opinions can provide high value when planning new management interventions [ 64 , 65 ]. In addition, using a multi-criteria decision analysis method proves to be useful for decisions so complex as those related to a merger process, and especially for its long-term sustainability [ 66 ].…”

Section: Discussionmentioning

confidence: 99%

Administration of Strategic Agreements in Public Hospitals: Considerations to Enhance the Quality and Sustainability of Mergers and Acquisitions

Monteros

Castro-Torres

Gómez‐Salgado

et al. 2021

IJERPH

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Merger processes between hospitals have high benefit potential for patients, staff and managers. This integration of health centres can improve the quality and safety in patient care. Additionally, cooperative processes enhance the sustainability of the health system, by increasing team spirit, giving innovative ideas and improving staff satisfaction. In this article, the critical factors for successful hospital mergers and acquisitions in the Public Health System were considered to develop a brief guide to help with the organisation of a merger process. Five sections were designed: Strategic administration and objectives, Staff management, New hospital complex structure, Processes and Results. This guide facilitates the communication between a variety of stakeholders, thus improving the engagement between all members of the new healthcare system. This could be particularly important for countries with large regional variance in the organisation of health care and resources.

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The problems of smaller, rural and remote hospitals: Separating facts from fiction

Cited by 34 publications

References 58 publications

The HINTS examination and STANDING algorithm in acute vestibular syndrome: A systematic review and meta-analysis involving frontline point-of-care emergency physicians

The HINTS examination and STANDING algorithm in acute vestibular syndrome: A systematic review and meta-analysis involving frontline point-of-care emergency physicians

Beyond patient care: a qualitative study of rural hospitals’ role in improving community health

Administration of Strategic Agreements in Public Hospitals: Considerations to Enhance the Quality and Sustainability of Mergers and Acquisitions

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