Rural Surgery and Status of the Rural Workplace: Hospital Survival and Economics

Surg Clin North Am. 2020 Oct;100(5):835-847. doi: 10.1016/j.suc.2020.05.009. Epub 2020 Jul 16.


Nearly 60 million people live in a rural area across the United States. Since 2005, 162 rural hospitals have closed, and the rate of rural hospital closures seems to be accelerating. Major drivers of rural hospital closures are poor financial health, aging facilities, and low occupancy rates. Rural hospitals are particularly vulnerable to policy and market changes, and even small changes can have a disproportionate effect on rural hospital financial viability. Surgery can be safely performed in rural hospitals; however, hospital closures may be putting the rural population at increased risk of morbidity and mortality from surgical disease.

Keywords: Access; Hospital closure; Rural; Surgery.

Publication types

  • Review

MeSH terms

  • Forecasting
  • Health Facility Closure / economics*
  • Health Facility Closure / statistics & numerical data*
  • Hospitals, Rural / economics*
  • Hospitals, Rural / statistics & numerical data*
  • Hospitals, Rural / trends
  • Humans
  • Rural Health Services / economics*
  • Rural Health Services / standards*
  • Rural Population
  • Surgical Procedures, Operative / statistics & numerical data*
  • Surgical Procedures, Operative / trends
  • United States
  • Workplace