10 Dec Physicians Leave Area Before and After Rural Hospitals Close

MedicalResearch.com Interview with:

Dr. Hayley Drew Germack

Hayley Drew Germack PhD
Assistant Professor of Acute and Tertiary Care
University of Pittsburgh School of Nursing

MedicalResearch.com: What is the background for this study?

Response: The rate of rural hospital closures has been increasing over the last ten years. Rural hospitals close for a number of reasons including poor hospital economic health tied to uncompensated care and community factors, like a local aging population.

Rural hospital and unit closures have been tied to decreased access to emergency and specialty care for patients including decreased access to obstetric-gynecological services and increase travel time for appointments. A recent paper also found a 6% increase in mortality in conditions needing emergent attention after rural hospital closures. We examined the impact of hospital closures in rural counties on the counties’ supply of physicians.

MedicalResearch.com: What are the main findings?

Response:  Using 20 years of health services data from the Area Health Resources Files, we found that rural hospital closures were associated with immediate and persistent decreases in the supply of surgical specialists and long-term decreases in the supply of physicians across multiple specialties—including an average annual 8.2 percent decrease in the supply of primary care physicians in the six years after a closure and beyond.

MedicalResearch.com: What should readers take away from your report?

Response: Physicians leave before and after a rural hospital closes. In an examination of 20 years of county-level data, we found that in rural counties, general surgeons started leaving in the 4 years leading up to a hospital closure. We also found significant decreases in the supply of primary care physicians and medical specialists after a closure. This decrease in supply could have significant repercussions for local availability to care.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: We recommend examining alternative sources of care other than hospitals for rural patients. We are also interested in the impacts on other critical members of the health care workforce outside of physicians.

Citation:

When Rural Hospitals Close, The Physician Workforce Goes

Hayley Drew Germack, Ryan Kandrack, and Grant R. Martsolf
Health Affairs 2019 38:12, 2086-2094 

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Last Updated on December 10, 2019 by Marie Benz MD FAAD