Rural Hospital Closures in the US South and Changes in Spatial Access to Acute Care, 2007-2018

Authors: Arrianna Marie Planey*, University of North Carolina, Chapel Hill, Donald A Planey, University of North Carolina, Chapel Hill, Sandy Wong, Florida State University, Sara L McLafferty, University of Illinois at Urbana Champaign, Michelle J Ko, University of California, Davis
Topics: Medical and Health Geography, Spatial Analysis & Modeling
Keywords: Health care access, spatial analysis, hospitals, hospital closures, rural health
Session Type: Virtual Paper
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The growing rate of rural hospital closures in the U.S. elicits concerns about declining access to hospital-based care. In this study, we describe changes in hospital supply accounting for closures, mergers and new construction, and corresponding spatial accessibility in rural areas of the U.S. South from 2007 to 2018. We linked data from the UNC Sheps Center for Health Services Research, the American Hospital Association Annual Survey, the U.S. Census Bureau, and The Henry J. Kaiser Family Foundation . We estimated network travel distance and time between the census tract-level population-weighted centroids to the nearest and next nearest operating acute hospital. We found that 74 hospitals closed, but due to mergers and consolidations, net hospital supply declined by 130. Nearly half of Census tracts experienced a increased minimum travel distances to care. Majority-Black rural tracts consistently had worse spatial access to hospital-based acute care throughout, with the greatest inequities in completely rural Black communities.

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