Using a novel integration of spatial analysis, multi-level modeling, and difference-in-difference tests, we propose to 1) investigate whether safety-net providers were more likely to defray the demand for services due to their proximity to hospitals that closed and 2) quantify the impact of hospital closures on rural mortality rates. The proposal aims to fill gaps in prior work by providing national estimates of impacts of hospital closures for rural populations due to changes to potential demand for services as well as in changes in health outcomes. Our study findings will provide new information on the cascading effect of increasing transportation times, social and economic conditions, and reduced access to healthcare providers on population health outcomes within rural communities.

Publications

• Changes in Socioeconomic Mix and Health Outcomes in Rural Counties with Hospital Closures, 2005-2018
  Policy Brief
  Rural and Minority Health Research Center
  Date: 09/2021
  This brief examines the trend of hospital closures between 2005 and 2018 across definitions of rurality. Social, economic, and health structure trends at the county level across the contiguous United States were the study's focus.