Responses to AIDS: large urban and small rural hospitals.

This study examines the assumptions that large urban hospitals will differ strikingly from small rural hospitals in their experience with AIDS patients, the staff-related problems caused by AIDS patients, and the administrative actions undertaken by the hospital in response. Results from a national stratified random sample of U.S. hospitals showed that by mid-1989 nearly all large urban hospitals had admitted AIDS patients, while only one-quarter of small rural hospitals had done so. Yet, over three-quarters of small rural hospitals have already adopted administrative policies about HIV testing of patients, and the contents of such policies differ little from those adopted by large urban hospitals. Despite similarity in official administrative responses, attitudinal differences exist. Staff fears of contagion and attitudes about isolation of HIV-positive patients are more evident in small rural hospitals; yet, recruitment difficulties triggered by staff concerns are greater in large urban hospitals.