Access to health care is an important issue, particularly in remote areas. Since 2010,
106 rural hospital have closed in the United States, potentially limiting geographic
access to health care. The aim of this study was to evaluate the impact of these hospital
closures on the proportion of the population who can reach a secondary care facility,
by road, within 15, 30, 45, or 60 min.
Geographical information system analysis, using population data obtained from the
2010 U.S. Census Bureau and hospital data between 2010 and 2019 from the Center for
Medicare and Medicaid Services, created 15-, 30-, 45-, and 60-min drive time isochrones
(areas from which a central location can be reached within a set time).
Rural hospital closures resulted in 0%-0.97% of the population no longer being able
to access a hospital within 15 min. The most marked changes were in the East South
Central (0.97%, 178,478 residents) and West South Central (0.54%, 197,660 residents)
divisions. Lesser degrees of change were noted for longer drive times. The changes
were more marked when the rural population was analyzed exclusively.
Recent closures of rural hospitals in the United States have impacted population access
to hospital care, although the extent varies. There are regions, such as the Southern
and Southeastern United States, which demonstrate greater and potentially more concerning
losses in population coverage, probably because of the greater number of closures.
Future work should evaluate clinical implications of hospital closures and loss of