The ‘Spillover Impact’ of Rural Hospital Closures

December 16, 2022

The closure of rural hospitals has a “spillover impact” for other nearby hospitals, leading to increased emergency department visits and inpatient admissions for surrounding facilities.

In a new report from the Penn State College of Medicine, researchers studied how so-called “bystander hospitals” were affected by the closure of rural hospitals. The report reviews the average rate of change for inpatient admissions and emergency department visits before and after a rural hospital closed. The results were recently published in the Journal of Hospital Medicine.

“This research confirmed a problem for the health care field that many already suspected,” Daniel George, associate professor of humanities and public health science, said in a statement. “The question now becomes how researchers and policymakers can develop solutions to help bystander hospitals handle increased volume.”

Among the key takeaways:

• Key finding:  Two years after the closure of a rural hospital, emergency department visits at nearby hospitals increased by an average of 10.22 percent. Average bystander hospital admissions also increased 1.17 percent in that span.
• Definitions:  Hospitals within a 30-mile radius of the closed hospital were deemed “bystander hospitals.”
• By region:  About 66 percent of the closures were in the southern U.S., and 21 percent were from the Appalachian region.
• The takeaway:  The closure of rural hospitals has a spillover impact on surrounding hospitals and poses a significant public health challenge in the U.S.
• Quotable:  “In the COVID-19 era, it will be especially necessary to focus on hospital closures given increased risk of maintaining solvency due to delayed and deferred care atop already tight margins,” the study authors concluded.

“Increased burden at bystander hospitals and health care institutions may cause these problems to proliferate if other public health interventions aren’t identified and implemented,” said Dr. Jennifer Kraschnewski, director of Penn State Clinical and Translational Science Institute.

HAP is committed to helping Pennsylvania’s rural hospitals address the financial challenges threatening their ability to deliver outstanding care. For example, Pennsylvania’s Rural Health Model provides a sustainable model of care, ensuring rural hospitals can count on stable revenue sources as they transform care in their communities.

The report is available to review online.