CONDITIONS AFFECTING RURAL HOSPITAL SPECIALIZATION, CONVERSION, AND CLOSURE - A CASE-BASED ANALYSIS OF THREAT AND CHANGE

The purpose of this analysis is to increase understanding of how and w hy rural hospitals change, with an eye toward the relevance of these q uestions to overall access and quality in the rural community. This st udy reports the threats that precipitated three major classes of organ ization change (specialization, conversion, and closure) in 16 rural h ospital cases. The authors identify the types and levels of threat fac ed by the case hospitals and examine how different threat situations m ay lead toward different classes of change. Conversions and closures t ypically seem to result from moderate- or high-threat situations. Spec ializations seem to result from low- or moderate-threat situations.