The evolution of rural hospitals viewed through a population ecology framework

Rural hospitals face formidable environmental challenges and have experienced closure rates higher than those of their urban counterparts. However, many of these rural hospitals appear to be surviving by developing interorganizational relationships that include network formation, absorption into investor-owned systems, and contract management arrangements. The concept of population ecology has been applied to organizational survival and can be used to examine health care organizations and specifically explain the evolution of rural hospitals. In this paper concepts from population ecology are used to explain the survival of rural hospitals and how new organizational structures are being developed to compensate for environmental changes.