Research Alert: April 19, 2021

Changes in Provision of Selected Services by Rural and Urban Hospitals Between 2009 and 2017

During the past decade, access to healthcare services provided by rural hospitals has changed in two major ways. First, there has been a substantial increase in the number of rural hospitals that have closed or converted (provide some healthcare services but not inpatient care). Secondly, and less understood, many rural hospitals have reduced or terminated services historically considered to be essential hospital services. This brief describes and compares the changes in service provision for rural and urban hospitals between 2009 and 2017.

• The percentage of rural hospitals that provided skilled nursing, obstetrics, labor and delivery, and home health services declined between 2009 and 2017.
• The percentage of rural hospitals that provided orthopedic services, oncology services, hospital-based outpatient services, emergency psychiatric services, and chemotherapy services increased between 2009 and 2017.
• Substantial differences in trends were observed between rural and urban hospitals. Across all selected services, there were no declines in the percentage of urban hospitals providing a service, with most services expanding in urban hospitals.

Additional Resources of Interest:

• More information about the North Carolina Rural Health Research and Policy Analysis Center
• More information from the Rural Health Information Hub's topic guides: Conducting Research, Needs Assessments, and Evaluations, Healthcare Access, Hospitals, Rural Health Policy