The Community Hospitals Association continues to make connections with community hospitals internationally, and to learn from studies and visits.
The CHA organised a visit by Simo Kokko from Finland, who has just carried out a major study exploring the use of community beds in community hospitals. With the CHA, Simo was invited to visit Crowborough Hospital and Rye Hospital in Sussex. The CHA is in the process of preparing papers for publication to reflect the findings of this study, drawing out comparisons between the models of care and contextual issues. The CHA has had a long association with Finland, with connections to Kekki in the 1980s, and visits to Finland in the 1990s as reported by Dr Roger Jones.
The CHA has been interested in the programme to develop community hospitals in Italy and we were pleased to meet Verdiana Morando University of Bocconi who talked of La Casa Della Salute (House of Health) and advised of the Government requirements for levels of intermediate care in every area.
Studies of community hospitals in Norway are contributing to our understanding of this model of care, and in particular the work of Garasen, Lappegard and Dhal as well as the earlier work of Aaraas. Their work has included assessing outcomes, cost, and quality. Norway has recognised the role of community hospitals in supplementing the work of the acute hospitals.
There has been a development of community hosptals in the Netherlands, with studies of the first community hospital by Charante showing that the community hospital was an alternative to acute care or care at home, and Roijen demonstrating that these services are a cost-saving alternative.
There is much to learn from the Canadian programme which has resulted in the closure of many rural hospitals. Studies that have explored the impact of the closures on communities and community health include those by Petruka and James.
The NIHR has funded Rand to carry out a study of community hospitals internationally, in order to share the learning across countries. The report concludes that the community hospital model is "fluid" and very often these small local hospitals are designed either to serve a designated geographical area or a patient cohort. The study identifies the role of community hospitals as an integrator. The report is now available.