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FACILITY CLOSURE: What happens when rural hospitals close? How are facilities reused?

This is a study of 47 rural hospitals that closed in 2010 to 2014.  It comes out of the North Carolina Rural Health Research Program.  The authors compare characteristics of hospitals that closed completely – which they term as “abandoned” – with those that are no longer providing inpatient care, but now have some other health care-related use – which they term as “converted.”

Of the 47 rural hospitals that closed, a little over half (26 hospitals) were in the abandoned category, and most of these were located in the South – particularly in Texas, Alabama, and Georgia.  The authors found that abandoned rural hospitals tended to be in markets with a higher percentage of non-white population compared to those hospitals that were converted to other health care use.

There is an interesting table included that looks at characteristics of rural hospitals in the year of closure.  Hospitals in the abandoned category had the lowest total margin in that final year – negative 10 percent, while those that were converted to other health care use were in somewhat better financial condition.  All of the rural hospitals that closed were small, with roughly 25 to 30 beds.

Ten of these hospitals converted to freestanding emergency or urgent care facilities; 4 converted to skilled nursing or rehabilitation facilities; and 7 converted to outpatient care.  The perceived impact of losing an inpatient hospital in a community is that patients will have to travel further to obtain care, that jobs will be lost (since the rural hospital is often the largest employer), and a loss of prestige in the community.

Source: Thomas, S.R., Kaufman, B.G., Randolph, R.K., and others. (2015, Apr.). A comparison of closed rural hospitals and perceived impact. Findings Brief.  http://www.shepscenter.unc.edu/wp-content/uploads/2015/04/AfterClosureApril2015.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org


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