title: General surgery at rural hospitals: a national survey of rural hospital administrators.
abstract: BACKGROUND
  Many rural residents have limited access to surgical care. Rural hospitals frequently struggle to provide surgical services due to workforce shortages and financial constraints. The purpose of this study is to describe rural hospital administrators' perceptions regarding the state of their general surgery programs and the impact that providing surgical services has on their hospitals' financial viability.
  
  
  METHODS
  A 12-item survey was mailed to a random sample of national rural hospital administrators (n=233). One hundred and eleven surveys were completed, yielding a response rate of 48%. In addition to overall descriptive analyses, comparisons were made between hospitals located in large versus small rural communities.
  
  
  RESULTS
  Eighty-three percent of rural hospital administrators perceived their surgical program to be very important to the financial viability of their hospital and stated that they would reduce services if the hospital were to lose its surgery program. Thirty-four percent of hospitals have a surgeon leaving within the next 2 years and more than one-third of hospital administrators are currently searching for a surgeon.
  
  
  CONCLUSIONS
  Surgical care is a vital component of the health care services delivered by rural hospitals. Surveyed administrators' view the ability to provide surgical services as crucial to the financial viability of their rural hospitals. A shortage of general surgeons is a potential major threat to these rural hospitals.
authors.affiliation: Mithoefer Center for Rural Surgery, Bassett Healthcare, One Atwell Road, Cooperstown, New York 13326, USA. brit.doty@bassett.org
authors.forename: Brit
authors.initials: B
authors.lastname: Doty
authors.forename: Randall
authors.initials: R
authors.lastname: Zuckerman
authors.forename: Samuel
authors.initials: S
authors.lastname: Finlayson
authors.forename: Paul
authors.initials: P
authors.lastname: Jenkins
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Rieb
authors.forename: Steven
authors.initials: S
authors.lastname: Heneghan
mesh_terms: D003710:Demography; D013502:General Surgery / Q000191:economics; D006740:Hospital Administrators; D019035:Rural Health Services / Q000191:economics; D011795:Surveys and Questionnaires; D014481:United States; D000078329:Workforce