Closing hospital wards jeopardizes the safe treatment of patients. The problem is particularly acute in smaller rural institutions. Direkt36 uses the story of a deceased pregnant woman to illustrate the deterioration of healthcare in the region.
Here are some leads - not all of these studies are truely “rockstars”, but they will lead you into the right direction if you follow their citations.
Myocardial Infarction:
Searcy R, Patel R, Drossopoulos P, Arora S, Stouffer GA. Rural-urban disparity in survival and use of PCI in patients who develop STEMI while hospitalized for a non-cardiac condition. Curr Probl Cardiol. 2025 Mar;50(3):102979. doi: 10.1016/j.cpcardiol.2025.102979. Epub 2025 Jan 10. PMID: 39800089
Sasaki K, Koeda Y, Yoshizawa R, Ishikawa Y, Ishida M, Itoh T, Morino Y, Saitoh H, Onodera H, Nozaki T, Maegawa Y, Nishiyama O, Ozawa M, Osaki T, Nakamura A. Comparing In-Hospital Outcomes for Acute Myocardial Infarction Patients in High-Volume Hospitals Performing Primary Percutaneous Coronary Intervention vs. Regional General Hospitals. Circ J. 2023 Sep 25;87(10):1347-1355. doi: 10.1253/circj.CJ-23-0188. Epub 2023 Aug 10. PMID: 37558468.
Saposnik G, Baibergenova A, O’Donnell M, Hill MD, Kapral MK, Hachinski V; Stroke Outcome Research Canada (SORCan) Working Group. Hospital volume and stroke outcome: does it matter? Neurology. 2007 Sep 11;69(11):1142-51. doi: 10.1212/01.wnl.0000268485.93349.58. Epub 2007 Jul 18. PMID: 17634420.
Tsai SHL, Goyal A, Alvi MA, Kerezoudis P, Yolcu YU, Wahood W, Habermann EB, Burns TC, Bydon M. Hospital volume-outcome relationship in severe traumatic brain injury: stratified analysis by level of trauma center. J Neurosurg. 2020 Mar 13;134(3):1303-1315. doi: 10.3171/2020.1.JNS192115. PMID: 32168482.
Trauma:
Tang A, Chehab M, Ditillo M, Asmar S, Khurrum M, Douglas M, Bible L, Kulvatunyou N, Joseph B. Regionalization of trauma care by operative experience: Does the volume of emergent laparotomy matter? J Trauma Acute Care Surg. 2021 Jan 1;90(1):11-20. doi: 10.1097/TA.0000000000002911. PMID: 32925573.
Nathens AB, Jurkovich GJ, Maier RV, Grossman DC, MacKenzie EJ, Moore M, Rivara FP. Relationship between trauma center volume and outcomes. JAMA. 2001 Mar 7;285(9):1164-71. doi: 10.1001/jama.285.9.1164. PMID: 11231745.
Let me know if you need more info on a specific field.
Sorry for the late reply.
Here are some leads - not all of these studies are truely “rockstars”, but they will lead you into the right direction if you follow their citations.
Myocardial Infarction: Searcy R, Patel R, Drossopoulos P, Arora S, Stouffer GA. Rural-urban disparity in survival and use of PCI in patients who develop STEMI while hospitalized for a non-cardiac condition. Curr Probl Cardiol. 2025 Mar;50(3):102979. doi: 10.1016/j.cpcardiol.2025.102979. Epub 2025 Jan 10. PMID: 39800089
Sasaki K, Koeda Y, Yoshizawa R, Ishikawa Y, Ishida M, Itoh T, Morino Y, Saitoh H, Onodera H, Nozaki T, Maegawa Y, Nishiyama O, Ozawa M, Osaki T, Nakamura A. Comparing In-Hospital Outcomes for Acute Myocardial Infarction Patients in High-Volume Hospitals Performing Primary Percutaneous Coronary Intervention vs. Regional General Hospitals. Circ J. 2023 Sep 25;87(10):1347-1355. doi: 10.1253/circj.CJ-23-0188. Epub 2023 Aug 10. PMID: 37558468.
Stroke/Traumatic brain injury: Quantifying Improved Outcomes, Cost Savings, and Hospital Volume Changes From Optimized Emergency Stroke Transport. (2022). Stroke,53 (12), 3644–3651. https://doi.org/10.1161/strokeaha.122.039172
Tepas JJ 3rd, Pracht EE, Orban BL, Flint LM. High-volume trauma centers have better outcomes treating traumatic brain injury. J Trauma Acute Care Surg. 2013 Jan;74(1):143-7; discussion 147-8. doi: 10.1097/TA.0b013e3182788b5a. PMID: 23271089.
Saposnik G, Baibergenova A, O’Donnell M, Hill MD, Kapral MK, Hachinski V; Stroke Outcome Research Canada (SORCan) Working Group. Hospital volume and stroke outcome: does it matter? Neurology. 2007 Sep 11;69(11):1142-51. doi: 10.1212/01.wnl.0000268485.93349.58. Epub 2007 Jul 18. PMID: 17634420.
Tsai SHL, Goyal A, Alvi MA, Kerezoudis P, Yolcu YU, Wahood W, Habermann EB, Burns TC, Bydon M. Hospital volume-outcome relationship in severe traumatic brain injury: stratified analysis by level of trauma center. J Neurosurg. 2020 Mar 13;134(3):1303-1315. doi: 10.3171/2020.1.JNS192115. PMID: 32168482.
Trauma: Tang A, Chehab M, Ditillo M, Asmar S, Khurrum M, Douglas M, Bible L, Kulvatunyou N, Joseph B. Regionalization of trauma care by operative experience: Does the volume of emergent laparotomy matter? J Trauma Acute Care Surg. 2021 Jan 1;90(1):11-20. doi: 10.1097/TA.0000000000002911. PMID: 32925573.
Nathens AB, Jurkovich GJ, Maier RV, Grossman DC, MacKenzie EJ, Moore M, Rivara FP. Relationship between trauma center volume and outcomes. JAMA. 2001 Mar 7;285(9):1164-71. doi: 10.1001/jama.285.9.1164. PMID: 11231745.
Let me know if you need more info on a specific field.
Thank you, this will take some time to go through haha. I’ll come back at you if I get the chance.
You are welcome - this is basically one of my specialities, even though my work focuses more on the prehospital fields.