Rural Health System Resources
BY RURAL PEOPLE FOR RURAL PEOPLE
Impact of rural hospital closures on hospitalizations and associated outcomes for ambulatory and emergency care sensitive conditions
Authors
Khushalani JS, Holmes M, Song S, Arifkhanova A, Randolph R, Thomas S, Hall DM.
Description
The purpose of this paper is to examine the impact of rural hospital closures on age-adjusted hospitalisation rates for ambulatory care sensitive condition (ACSC) and emergency care sensitive condition (ECSC) and associated outcomes, such as length of stay and in-hospital mortality in hospital service areas (HSAs) that utilized the closed hospital. Rural hospital closures were associated with increase in ambulatory care sensitive condition admissions right before closure and for nearly 2 years post closure as well as decrease in emergency care sensitive condition admissions before closure. As rural hospitals continue to close, efforts to ensure communities affected by these closures maintain access to primary health care may help eliminate increases in costly preventable hospital admissions for ambulatory care sensitive condition while ensuring access for emergency care services.
Why is this useful for rural and remote people?
This loss of rural health and hospital services affects the social, economic and health outcomes of rural and remote people. For example, if an on-site GP/VMO service at a local hospital is replaced by a virtual emergency doctor, this will result in avoidable hospitalisations and deaths due to the lack of immediate on-site care in an emergency. This article examines the impact in the United States of rural hospital closures, but is equally relevant for rural and remote people in Australia who are advocating to retain local health care services or to increase investment in local health solutions. It demonstrates the short and long term health impacts of losing local emergency and acute care services on rural people, and how withdrawing funding leads to higher rates of hospital admissions and service demand increasing system costs.
Suggested Citation
Khushalani JS, Holmes M, Song S, Arifkhanova A, Randolph R, Thomas S, Hall DM. Impact of rural hospital closures on hospitalizations and associated outcomes for ambulatory and emergency care sensitive conditions. J Rural Health. 2023 Jan;39(1):79-87. doi: 10.1111/jrh.12671. Epub 2022 May 5. PMID: 35513356.
at
