U.S. Department of Health and Human Services data were
analyzed to compare rural and urban hospitals on two
metrics: 1) the percentage of hospitalized patients with
COVID-19, and 2) the percentage of hospital beds occupied
by patients that have COVID-19.
Rural hospitals have a higher percentage of hospitalized
COVID-19 patients than urban hospitals. In most census
divisions, the percentages of currently hospitalized
patients with COVID-19 are higher in rural hospitals than
in urban hospitals. Figure 1 shows the percent, among all
patients in the hospital, with COVID-19. In the Midwest
and South, rural hospitals are four to eight percentage
points higher, indicating COVID-19 patients are
relatively more common in rural hospitals in those
Rural hospitals have more relative bed capacity than
urban hospitals, but they may face great challenges with
staffing. In all census divisions, rural hospitals have a
higher percentage of available beds than urban hospitals.
This suggests that some rural hospitals may prove an
effective "safety valve" as urban hospitals reach
capacity. Some state policies have increased payment for
rural hospitals willing to treat urban overflow patients
with COVID-19. Of course, many rural hospitals face
challenges in staffing these open beds.
Policy Implications: Tighter capacity in urban hospitals
could limit rural residents' ability to access advanced
healthcare services (including ICU beds and ventilators)
if urban hospitals limit or reject transfers. Rural
hospitals may be able to accept low-acuity patients
transferred from urban hospitals to expand capacity.