Rural Health
Research Gateway

Research Alert: October 15, 2024

The First Year of Rural Emergency Hospitals: REHs Serve Relatively Disadvantaged Counties

This brief provides a preliminary look at the types of communities with hospitals that converted to Rural Emergency Hospitals (REHs) in 2023. Researchers: 1) describe the socio-economic, race and ethnicity, and health status and access characteristics of the communities served by REHs, and 2) compare the characteristics of counties served by REHs to counties that experienced a recent rural hospital closure and to all other rural counties.

Key Findings:

  • Sixteen of the 19 hospitals that converted to REH, open at the end of 2023, were in the South.
  • Various hospital types converted to REHs in 2023: seven were Sole Community Hospitals, six were Critical Access Hospitals, four were Prospective Payment System hospitals, and two were Medicare Dependent Hospitals.
  • Counties with REH conversions were relatively challenged, showing highest median rates of poverty (16.3% versus 13.4% in counties with a rural hospital closure, and 13.0% in all other rural counties), uninsured individuals (19.4% versus 13.0% in counties with a rural hospital closure, and 13.1% in all other rural counties), and people in poor or fair health (25.8% versus 21.7% in counties with a rural hospital closure, and 20.4% in all other rural counties).
  • Counties with a REH conversion also faced health care access challenges, with fewer primary care and mental health providers and higher emergency department visit rates among Medicare beneficiaries.
Contact Information:

George H. Pink, PhD
North Carolina Rural Health Research and Policy Analysis Center
Phone: 919.966.5011
gpink@email.unc.edu

Additional Resources of Interest: