Perceptions of access to care after a rural hospital closure in an economically distressed county of Appalachian Tennessee

Author:

Letheren Amanda12,Brown Kathleen C.2ORCID,Barroso Cristina S.3,Myers Carole R.3,Nobles Robert4

Affiliation:

1. Public Health and Healthcare Oak Ridge Associated Universities Oak Ridge Tennessee USA

2. Department of Public Health University of Tennessee Knoxville Tennessee USA

3. College of Nursing University of Tennessee Knoxville Tennessee USA

4. Research Administration Emory University Atlanta Georgia USA

Abstract

AbstractPurposeThe rise in rural hospital closures has sparked concern about the potential loss of essential health care services for rural communities. It is crucial to incorporate the perspectives of community residents, which have been largely missing from the literature, when devising strategies to improve health care for this population. The purpose of this study was to describe community residents’ perceptions of access to care following a rural hospital closure in an economically distressed Appalachian county of Tennessee.MethodsThis study used a qualitative descriptive approach to illustrate how community residents perceive accessing care post hospital closure. We conducted semi‐structured interviews with 24 community residents via telephone in May through August of 2020. Interviews were analyzed using conventional content analysis.FindingsFive themes were identified based on Penchansky and Thomas’ framework of health care: accessibility, availability, affordability, accommodation, and acceptability. Accessibility was identified as the most common concern among participants. Specifically, participants perceived longer travel times to receive care, reduced availability of emergency and specialty care, increased costs associated with ambulance services, and extended wait times to see providers.ConclusionsOur findings provide a critical perspective to inform local leaders and policymakers on the impacts of a hospital closure in a rural community. As rural hospitals continue to close, it is crucial to develop multi‐level, community‐driven solutions to ensure access to care for rural communities.

Publisher

Wiley

Subject

Public Health, Environmental and Occupational Health

Reference48 articles.

1. Sheps Center for Health Services.192 Rural Hospital Closures and Conversions since January 2005. Accessed July 23 2023.https://www.shepscenter.unc.edu/programs‐projects/rural‐health/rural‐hospital‐closures/

2. Tennessee Justice Center.Mckenzie Regional Hospital Closure and Tennessee's Silent Epidemic. Accessed July 5 2022.https://www.tnjustice.org/mckenzie‐regional‐hospital‐closure‐rural‐tennessee/

3. MarshallJL ThomasL LaneNM et al.Health Disparities in Appalachia.2017. Accessed July 5 2022.https://www.arc.gov/report/health‐disparities‐in‐appalachia/

4. Appalachian Regional Commission.The Appalachian Region. Accessed April 30 2023.https://www.arc.gov/appalachian_region/TheAppalachianRegion.asp

5. Universityof Wisconsin Population Health Institute.County Health Rankings Model.2021. Accessed September 12 2023. https://www.countyhealthrankings.org/explore‐health‐rankings/measures‐data‐sources/county‐health‐rankings‐model

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