Patterns of Hospital Bypass and Inpatient Care-Seeking by Rural Residents


Hospital bypass, the tendency of local rural residents to not seek care at their closest hospital, is thought to be a contributing factor for rural hospital closure. The purpose of this brief is to update the knowledge base of determinants of bypass behavior by analyzing state inpatient data from 2014-2016 across 16 diverse states. Our results suggest that inpatient bypass behavior is driven by both hospital-level and patient-level characteristics. In comparison to other rural hospitals, rural hospitals are more likely to be bypassed by local residents if they are a Critical Access Hospital, smaller, less profitable, and do not offer obstetric service. Individuals who did not bypass their local rural hospital were more likely to belong to vulnerable populations.

North Carolina Rural Health Research and Policy Analysis Center
Tyler Malone, Mark Holmes