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When Rural Hospitals Close, Nearby Hospitals Suffer
  • Posted December 23, 2022

When Rural Hospitals Close, Nearby Hospitals Suffer

When rural hospitals shut down people need to go elsewhere, and a new study finds that nearby hospitals bear the strain of that patient overflow.

"Previous studies have shown that rural hospital closures can have negative health consequences for the communities they serve," said researcher Daniel George, an associate professor of humanities and public health sciences at Penn State College of Medicine.

"We predicted that closures would, over time, lead to increased strain on bystander institutions," George said in a college news release.

More than 180 rural hospitals throughout the United States have closed since 2005. Nearly 1,000 more are at risk of closing, according to the study. The researchers focused on so-called bystander hospitals located within about a 30-mile radius of the closed sites.

Using the University of North Carolina's Sheps Center for Health Services Research database, researchers studied rural U.S. hospitals that had a more than 25-bed capacity and closed between 2005 and 2016. They examined the rate of change for admissions and emergency department visits for surrounding hospitals both two years before and two years after each closure.

The study revealed 53 closures and 93 bystander hospitals that met the criteria, about 66% of which were in the South. About 21% were from the Appalachian region.

While average emergency visits at bystander hospitals increased 3.6% in the two years before the hospital closures, they grew by 10.2% in the two years afterward. Meanwhile, average admissions dropped by about 5.7% in the two years prior to the closures and grew 1.2% in the two years after.

"This research confirmed a problem for the health care field that many already suspected," George said. "The question now becomes how researchers and policymakers can develop solutions to help bystander hospitals handle increased volume."

The findings were published recently in the Journal of Hospital Medicine. The National Center for Advancing Translational Sciences supported the research.

"We know rural areas, especially regions like Appalachia, are at increased risk for diseases of despair including alcoholism, accidental poisonings and suicide," said co-author Dr. Jennifer Kraschnewski, director of the Penn State Clinical and Translational Science Institute.

"Increased burden at bystander hospitals and health care institutions may cause these problems to proliferate if other public health interventions aren't identified and implemented," she said in the release.

More information

The U.S. Centers for Disease Control and Prevention has more on rural health care.

SOURCE: Penn State College of Medicine, news release, Dec. 13, 2022

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