Objective: To compare the medical services provided in small hospitals in Ontario in 1995 with those provided in 1988.
Design: Mailed survey questionnaire.
Setting: Small hospitals in Ontario.
Participants: Chiefs of Staff of the hospitals.
Main outcome measures: Hospital size and location; numbers of physicians; availability of obstetric, anesthesia, and general surgery services; and other medical services available. The 1995 questionnaire was identical to the 1988 one, except for addition of questions on midwives and deletion of the detailed emergency medicine section.
Results: Sixty hospitals responded in both years. In these hospitals, there were significantly fewer acute care beds and births in 1995 than in 1988. Availability of general anesthesia and general surgery was significantly reduced, although general anesthesia was administered and general surgeries were performed more often. There were significantly fewer GP anesthetists and significantly fewer family physicians who attended births, although there were slightly more family physicians overall. There were fewer specialists.
Conclusion: These are negative trends, particularly for women giving birth and patients needing emergency surgery in rural Ontario.