Access to care in rural America: impact of hospital closures

Health Care Financ Rev. 1995 Fall;17(1):15-37.


This article employs a quasi-experimental, pre/post comparison group design to determine whether rural hospital closures (n = 11) have had a detrimental impact on access to inpatient and outpatient care for the Medicare population. Closure areas experienced a significant decrease in medical admissions, although admission rates remained higher than in comparison areas. Physician services were not found to substitute for inpatient services following a closure. No adverse impacts on mortality were observed. Patients in closure areas were more likely to be admitted to urban teaching hospitals following the closure of their local hospital.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Health Facility Closure / economics
  • Health Facility Closure / statistics & numerical data*
  • Health Services Accessibility / statistics & numerical data*
  • Health Services Research
  • Hospitals, Rural / economics
  • Hospitals, Rural / supply & distribution*
  • Medicare Part A / economics
  • Medicare Part A / trends
  • Medicare Part B / economics
  • Medicare Part B / trends
  • Outcome Assessment, Health Care
  • Rural Population
  • United States
  • Utilization Review