Date of Conferral



Doctor of Nursing Practice (DNP)




Janice M. Long


Closure of community hospitals directly impacts the health of rural populations and indirectly affects economic growth and access to medical services. The purpose of this doctoral project was to assess the causes and impacts of hospital closures on rural communities. The practice-focused question addressed the implications of hospital closures on individuals and families in rural communities. A systematic review of the literature, based on conflict theory, addressed populations that lack health care facility resources. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided the selection of 8 journal articles for review. The inclusion criteria for articles encompassed the impact of closure of health care facilities on the rural community and if the information about the causes of closure of health care facilities provided recommendations about hospital closure. The John Hopkins Nursing Evidence-Based Practice Rating Scale framework was used to determine the level and quality of evidence of the journal articles selected for review. Findings indicated that hospital closure has a negative effect on rural residents' health due to prolonged travel time for patients to access care, deterioration of health when access is not possible and increased expenses for services from remote locations. Loss of jobs due to hospital closure results in loss of income and decreased access to affordable care for community members. Findings from this project may be used to promote social change for regional and national stakeholders as the project raises awareness of the need to be diligent in preserving and enhancing health services in rural areas.