Access To Obstetric, Behavioral Health, And Surgical Inpatient Services After Hospital Mergers In Rural Areas

Area of Science:

• Health Services Research
• Rural Health Policy
• Hospital Management

Background:

• Rural hospitals are vital community assets facing significant financial challenges.
• Hospital mergers are a common strategy to address financial distress.
• Mergers can lead to service line rationalization, impacting community access to care.

Purpose of the Study:

• To examine the impact of rural hospital mergers on inpatient service line changes.
• To assess how mergers affect service availability within merged hospitals and their surrounding communities.
• To identify potential disparities in care access following rural hospital consolidation.

Main Methods:

• Analysis of hospital discharge data from 32 State Inpatient Databases (2007-2018).
• Comparison of service line changes in merged rural hospitals versus independent rural hospitals.
• Examination of changes within hospital service lines and broader catchment areas.

Main Results:

• Merged hospitals were more prone to eliminating maternal/neonatal and surgical services compared to independent hospitals.
• Mental/substance use disorder service utilization decreased or stagnated at merged facilities and their catchment areas.
• Unaffiliated hospitals saw an increase in mental/substance use disorder stays, suggesting a potential unmet need post-merger.

Conclusions:

• Rural hospital mergers, while potentially improving financial stability, can result in reduced service offerings.
• Consolidation may exacerbate unmet community needs, particularly for mental and substance use disorder care.
• Policymakers should consider the implications of mergers on service accessibility and community health outcomes in rural areas.