Document Type

Article

Publication Date

6-15-2016

Publication Title

Journal of the Georgia Public Health Association

DOI

10.21663/jgpha.5.417

Abstract

Background: Critical access hospitals provide several essential services to local communities. Along with the functions associated with providing necessary medical care, they also offer employment opportunities and other economic benefits to the communities they serve. Since 2010, the number of rural hospitals closures has steadily increased. The common-good approach to ethical decision-making provides a framework that aids in evaluation of the effects that hospital closures have on rural residents and communities.

Methods: This analysis includes results of a systematic overview of peer-reviewed literature to address the following research questions: 1) How have state policies and the adoption of Medicaid expansion influenced the viability or rural hospitals? 2) What are the ethical implications of Medicaid expansion and state policy reform/adoption pertaining to viability of rural hospitals? and 3) What are the ethical implications of critical access hospitals closures on rural communities in Georgia? Information related to these questions is presented, along with tactics to addressing these in an ethical manner.

Results: This descriptive analysis shows that the largest number of state-specific closures have occurred in states with a federal exchange and which chose not to expand Medicaid. Characteristics of the state of Georgia and the counties with recent closures show that these counties typically have smaller populations with a high minority presence, lower education and income levels, and higher numbers of medically uninsured.

Conclusions: The common-good approach to ethical decision-making is suitable for evaluating the ethical implications of policy-level decisions impacting the closure of critical access hospitals serving the rural communities of Georgia.

Comments

Copyright Statement: Copyright © Randi G. Bastian, Marcus Garner, John S. Barron, Emmanuel A. Akowuah, and William A. Mase. Originally published in jGPHA (http://www.gapha.org/jgpha/) June 15, 2016. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No-Derivatives License (http://creativecommons.or/license/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work ("first published in the Journal of the Georgia Public Health Association...") is properly cited with original URL and bibliographic citation information. The complete bibliographic information, a link to the original publication on http://www.gapha.jgpha.org/, as well as this copyright and license information must be included.

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