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Rural Health
Resources by Topic: Closures of healthcare facilities and services

An Enhanced Method for Identifying Hospital-Based Obstetric Unit Status
Results of a study using data from American Hospital Association annual surveys from 2010-2018 to conduct single- and multi-year assessments of obstetric unit status and to identify closures of obstetric units. Compares results obtained through the enhanced method with results of a survey sample of rural hospitals with obstetric units open at the time of the assessment and those with recently closed units.
Author(s): Julia D. Interrante, Caitlin Carroll, Sara C. Handley, Katy Kozhimannil
Date: 01/2022
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Provider and Patient Perspectives on Labor and Delivery Unit Closures in Rural New Hampshire
Explores how the closure of labor and delivery units in New Hampshire has impacted the providers and patients in the affected communities. Describes the top reasons for labor and delivery unit closures among five hospitals, staffing challenges, and the effect of closures on prenatal and postpartum care for women in the community. Presents recommendations to ensure access to safe and secure pregnancies and deliveries after closures.
Author(s): Sarah Benatar, Stacey McMorrow, Timothy J. Fisher
Date: 12/2021
Type: Document
Sponsoring organization: Urban Institute
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For-profit Hospitals as Anchor Institutions in the United States: A Study of Organizational Stability
Examines whether for-profit hospitals are stable enough to fulfill the role of long-standing anchor institutions through a long-term presence in communities. Analyzes if for-profit hospitals had higher odds of closing and merging, and discusses the potential economic contributions of for-profit anchor institution hospitals to the surrounding community. Includes statistics by hospital characteristics, including rural location, and a discussion of rural hospital closures.
Author(s): Berkeley Franz, Cory E. Cronin, Vanessa Rodriguez, et al.
Citation: BMC Health Services Research, 21
Date: 12/2021
Type: Document
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Access to Outpatient Services in Rural Communities Changes after Hospital Closure
Examines trends of Federally Qualified Health Center (FQHC) and Rural Health Quality (RHC) availability in rural areas before and after hospital closures. Explores the associations between poverty rates and access to FQHCs and RHCs following hospital closure.
Author(s): Katherine E. M. Miller, Kyle L. Miller, Kathleen Knocke, et al.
Citation: Health Services Research, 56(5), 788-801
Date: 10/2021
Type: Document
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Rural Emergency Hospital: Policy Brief and Recommendations to the Secretary
Describes the development of the Rural Emergency Hospital (REH) designation in response to rural hospital closures and issues accessing emergency care. Lists statutory requirements for hospitals wishing to become an REH, and offers policy recommendations related to participation conditions, quality reporting, reimbursement, and emergency medical transfer agreement.
Date: 10/2021
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Mapping the Location of Health Centers in Relation to "Maternity Care Deserts": Associations With Utilization of Women's Health Providers and Services
Explores the association between community health centers' (CHC) distance to a maternity care desert (MCD) and use of maternity-related healthcare services. Discusses the effects of rural hospital closures and provider shortages on patients' access to maternity care. Includes a county-level MCD map and county-level and CHC-level statistics related to MCDs.
Author(s): Anne R. Markus, Drishti Pillai
Citation: Medical Care, 59(10), S434-S440
Date: 10/2021
Type: Document
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Following Labor and Delivery Unit Closures in Rural New Hampshire, Driving Time to the Nearest Unit Doubled
Examines the impact of the closure of 9 labor and delivery units in rural New Hampshire on the driving time to open units between 2000 and 2018. Explores the association between proximity to an open labor and delivery unit and women's health and socioeconomic characteristics.
Author(s): Stacey McMorrow, Sarah Benatar, Timothy J. Fisher
Date: 10/2021
Type: Document
Sponsoring organization: Urban Institute
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The Association Between System Affiliation and Financial Performance in Critical Access Hospitals
Examines the association between Critical Access Hospital (CAH) health system affiliation and financial performance as measured by the Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS). Discusses trends in health system affiliation as an alternative to closures as well as potential downsides of affiliation.
Author(s): Laura Bozovich, Kathleen Knocke, George Pink, Ann Howard, Kristin L. Reiter
Date: 10/2021
Type: Document
Sponsoring organization: Flex Monitoring Team
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Partnerships, Mergers, and Acquisitions Can Provide Benefits to Certain Hospitals and Communities
Discusses challenges hospitals may face to increasing the scale of operations. Describes how partnerships, mergers, and acquisitions can help prevent hospital closure and preserve access, enhance patient care, and reduce costs. Includes examples of how four acquired hospitals in rural communities benefited from capital investments and improvements.
Date: 10/2021
Type: Document
Sponsoring organization: American Hospital Association
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Availability of Post-Acute Care and Long-Term Care Services in Rural Areas
September 14, 2021 webinar discussing the availability of post-acute care and long-term services in rural areas. Shares information on nursing home closures, nursing home deserts, and data describing nursing homes characteristics by metro and nonmetro location. Includes an analysis of hospitals with swing beds that provide coverage for post-acute care and long-term services in rural areas and home health services in rural areas without nursing homes.
Additional links: Presentation Slides, Transcript
Author(s): Hari Sharma
Date: 09/2021
Type: Video/Multimedia
Sponsoring organization: Rural Health Research Gateway
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