Obstetric Care Access Declined In Rural And Urban Hospitals Across US States, 2010-22.

Area of Science:

• Healthcare access
• Maternal health
• Rural health disparities

Background:

• The closure of obstetric services in US hospitals, particularly in rural areas, is a growing concern.
• Understanding the trends and geographic distribution of these closures is crucial for public health.
• Existing literature highlights the impact of hospital closures on healthcare access, but specific obstetric service line trends require detailed analysis.

Purpose of the Study:

• To identify the obstetric service status for all rural and urban short-term acute care hospitals across the United States.
• To quantify the proportion of hospitals that closed their obstetric service lines between 2010 and 2022.
• To analyze the prevalence of hospitals without obstetric services by state and hospital type (rural/urban).

Main Methods:

• Data on hospital obstetric service status was collected for all short-term acute care hospitals in the US.
• The study period spanned from 2010 to 2022.
• State-level and national-level analyses were conducted to determine the percentage of hospitals closing obstetric service lines and the proportion of hospitals lacking these services.

Main Results:

• Seven states experienced at least a 25% closure rate of hospital obstetric service lines between 2010 and 2022.
• By 2022, over two-thirds of rural hospitals in eight states were operating without obstetric services.
• The data indicates a significant trend of diminishing obstetric care availability, particularly affecting rural communities.

Conclusions:

• The closure of obstetric service lines is a significant issue in numerous US states, with a disproportionate impact on rural hospitals.
• These findings underscore a critical decline in obstetric care access, necessitating urgent attention and policy interventions.
• Further research is needed to explore the drivers of these closures and their downstream effects on maternal and infant health outcomes.