title: Access to care in rural America: impact of hospital closures.
abstract: 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.
authors.affiliation: Center for Health Economics Research, Waltham, MA 02154, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Rosenbach
authors.forename: D A
authors.initials: DA
authors.lastname: Dayhoff
mesh_terms: D006271:Health Facility Closure / Q000191:economics / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006302:Health Services Research; D006780:Hospitals, Rural / Q000191:economics / Q000600:supply & distribution*; D016344:Medicare Part A / Q000191:economics / Q000639:trends; D016345:Medicare Part B / Q000191:economics / Q000639:trends; D017063:Outcome Assessment, Health Care; D012424:Rural Population; D014481:United States; D014600:Utilization Review