지역 종합병원 폐업의 사회적 영향과 지역사회 대응에 관한 다중사례연구

초록

= Abstract = Objectives: This study examined two cases of general hospital closure in local health care systems. It aimed to identify the impacts of hospital closure on local communities from the perspectives of residents, patients, and hospital employees, and to analyze the conditions shaping community responses after closure. Methods: A multiple-case study design was applied. Media reports and administrative documents were reviewed, and in-depth interviews were conducted with 18 participants, including public health center officials, local residents, hospital employees, and civic organization members. Interview data were analyzed using thematic analysis, followed by cross-case analysis and pattern matching. Results: The two hospitals performed public functions in local health care systems but shared financial and governance vulnerabilities as private institutions. Public health centers intervened during closure, yet their role was limited because hospital operation and closure were largely treated as matters of private management. After the closures, residents experienced a sense of loss and anxiety about emergency care gaps, patients faced reduced access to care and disrupted continuity of care, and employees experienced wage arrears, income loss, reemployment difficulties, psychological distress, and social withdrawal. Community responses varied by perceived service gaps, organizational infrastructure and leadership, awareness of local inequality, evaluation of local government responses, and historical frames regarding local health care and hospitals. Conclusions: The closure of local hospitals directly affects the essential foundations of residents’ lives. Public management and accountability in the health care delivery system should be strengthened. Knowledge that connects individual suffering to broader structural conditions is also essential for enabling communities to articulate political demands.

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