December 20, 2019

CHOICE Institute Researchers Find that Rural Hospital Closures Increase Patient Mortality

Dr. Kritee Gujral

Dr. Kritee Gujral

About 15% of hospitals have closed since 1990, and rates of hospital closure—particularly in rural areas—have increased over the last decade.

Dr. Kritee Gujral and Dr. Anirban Basu’s recent National Bureau of Economic Research (NBER) working paper, “The Impact of Rural and Urban Hospital Closures on Inpatient Mortality,” which used California’s inpatient data from 1995-2011, showed that rural closures increase patient mortality by 5.9%, whereas urban closures have no measurable impact.

As previous studies had provided mixed evidence regarding the impact of closures on patients, with no large-scale published study showing adverse patient impact of hospital closures, their work calls attention

Dr. Anirban Basu

Dr. Anirban Basu

to this important issue and its patient-level impact, as hospital closures, especially in rural areas, are on the rise. Policymakers should ensure that patients, particularly vulnerable ones, have access to emergency transportation following a hospital closure, the authors say.

This work has received press coverage by several media outlets: NBC news, The Daily Yonder, The Brookings Institution, Center for American Progress, Iowawatch.org, and Iowa Public Radio. Dr. Gujral was also invited to present and share their findings to key individuals from Federal Office of Rural Health Policy and Office of Planning, Analysis, and Evaluation at the Health Resources and Services Administration.

Kritee Gujral is a postdoctoral fellow at the CHOICE Institute currently on the job market. Learn more about Kritee and her research.