Since the onset of COVID-19, public health leaders have
emphasized reducing the rate of viral spread to ensure
that hospitals did not become overwhelmed. On December
15, 2020, the U.S. Department of Health and Human
Services published weekly data on each individual
hospital's status on indicators for acute management of
COVID-19 patients. These data were analyzed to compare
the percentage of hospitalized patients with COVID-19 in
rural versus urban hospitals.
Rural hospitals have a higher percentage of patients with
COVID-19 than urban hospitals. Figure 1 shows that,
although it has been increasing in both urban and rural
hospitals, the percentage of patients with COVID-19 has
been four to six percentage points higher in rural
hospitals since October.
The percentage of hospitalized patients with COVID-19 is
higher in rural hospitals than in urban hospitals in most
census regions. The percentage of hospitalized patients
with COVID-19 is higher in rural hospitals than in urban
hospitals in the Midwest and South and about the same in
the Northeast and West. Figures 2 and 5 show that the
difference between rural and urban hospitals in the South
have largely remained constant, and the difference in the
Midwest grew considerably.
Policy implications: A higher percent of hospitalized
patients have COVID-19 in rural hospitals than in urban
hospitals. Because staffing can be more difficult to
maintain in rural hospitals, the higher exposure in rural
hospitals may put their staffs – and the hospitals they
work in – at greater risk to maintain peak care capacity.