Table 1
Definitions of ‘community hospital’.
| Definition | Reference |
|---|---|
| A general practitioner community hospital can be defined as a hospital where the admission, care and discharge of patients is under the direct control of a general practitioner who is paid for this service through a bed fund, or its equivalent. | Liaison Group of the Royal College of General Practitioners the Association of General Practitioner Community Hospitals Royal College of General Practitioners (1990) [2] |
| A community hospital is a local hospital, unit or centre providing an appropriate range and format of accessible health care facilities and resources. Medical care is normally led by GPs, in liaison with consultant, nursing and allied health professional colleagues as necessary and may also incorporate consultant long stay beds, primary care nurse-led and midwife services. | Ritchie (1996) [80] |
| Many countries have a lower tier of hospital, sometimes called a community hospital. These typically have 50 beds or less and provide basic diagnostic services, minor surgery and care for patients who need nursing care but not the facilities of a district general hospital. | McKee and Healy (2002) [81] |
| A service which offers integrated health and social care and is supported by community-based professionals. | UK Department of Health (2006) [4] |
| A local hospital, unit or centre community based, providing an appropriate range and format of accessible health care facilities and resources. These will include inpatient beds and may include outpatients, diagnostics, surgery, day care, nurse led, maternity, primary care and outreach services for patients provided by multidisciplinary teams. | Community Hospitals Association (2008) [78] |
Table 2
Inclusion and exclusion criteria.
| Inclusion criteria | Exclusion criteria | |
|---|---|---|
| Setting | High income country with comparable health care systems that provide universal access (ie Canada, Australia, NZ and high income countries in Europe) | Low- and middle- income country ; non-European country (except Canada, Australia, NZ) |
| Facility type | Meets all of the following criteria:
| Facility that offers specialist services only GP- or nurse-led beds within secondary or tertiary hospitals |
| Outcomes | A description of the nature and scope of delivery models or services provided | Provides synthesis and discussion of the delivery model only Does not describe the delivery model or services provided by individual community hospitals |
| Study type | Experimental study (randomised control study (RCT), cluster-randomised controlled trial, quasi-randomised controlled trial), and observational study | Editorial, commentary, review |
| Publication type | Journal article, report, dissertation, book and professional journal | Conference abstract, study protocol |
| Publication year | Published in 2005 and after | Published before 2005 |
| Language | All languages | n/a |
Figure 1
Flow chart depicting literature search and exclusion process.
Table 3
Overview of services provided by community hospitals in different countries.
| Country | Number of papers retrieved | Facility designation | Services discussed in the literature | Staffing |
|---|---|---|---|---|
| England and Wales | 36 | Community hospital | A large proportion of articles focused on non-acute inpatient services e.g. post-acute care, rehabilitation or palliative care. Fewer articles looked at outpatient services, urgent care such as in minor injury units, and acute inpatient care. Other services that were discussed more rarely include health promotion, surgery, mental health care, primary care, social care and maternity care | Care led by GPs, nurses and/or community geriatricians, supported by specialist consultants and other practitioners |
| Scotland | 6 | Community hospital | Articles reported on non-acute inpatient services, outpatient services, urgent care services, acute inpatient care, surgery, mental health care and maternity care. | Not reported |
| Norway | 6 | Intermediate care hospitalCommunity hospital | All articles discussed provision of non-acute inpatient services, particularly intermediate care. Other services included outpatient services, urgent care services, acute inpatient care, mental health care and maternity care. | GPs, nurses and allied health professionals |
| New Zealand | 6 | Rural hospital | Articles reported on the provision of non-acute inpatient services, outpatient services, urgent care services, acute inpatient care, surgery, and primary care | GPs, Medical Officers of Special Scale, nurses and allied health professionals. Visiting specialists |
| Australia | 15 | Rural hospitalRegional hospitalBase hospital | Articles reported on the provision of non-acute inpatient services, outpatient services, urgent care services, acute inpatient care, surgery, and primary care | GPs, nurses, midwives and allied health professionals |
| Canada | 2 | Rural hospital | Articles report on provision of acute and non-acute inpatient care, urgent care services, surgery, mental health care and maternity care | Family physicians |
| Greece | 1 | Hospital-health centre | The article reports on provision of inpatient, outpatient, primary care and preventative health services | Doctors and nurses |
| Ireland | 2 | Community hospital | The articles report on provision of non-acute inpatient services and outpatient services | Nurses and allied health professionals, with input from GPs and geriatricians |
| The Netherlands | 1 | General practitioner hospital | The article reports on provision of acute and non-acute inpatient care, outpatient services. | GPs and nurses with support from paramedics and specialists |
Figure 2
Nature and scope of services provided by CHs.