Access, Quality, And Financial Performance Of Rural Hospitals Following Health System Affiliation.
Health Aff (Millwood)
; 38(12): 2095-2104, 2019 12.
Article
en En
| MEDLINE
| ID: mdl-31794306
ABSTRACT
More than 100 rural hospitals have closed since 2010. Some rural hospitals have affiliated with health systems to improve their financial performance and potentially avoid closure, but the effects of affiliation on rural hospitals and their patients are unclear. To examine the relationship between affiliation and performance, we compared rural hospitals that affiliated with a health system in the period 2008-17 and a propensity score-weighted set of nonaffiliating rural hospitals on twelve measures of structure, utilization, financial performance, and quality. Following health system affiliation, rural hospitals experienced a significant reduction in on-site diagnostic imaging technologies, the availability of obstetric and primary care services, and outpatient nonemergency visits, as well as a significant increase in operating margins (by 1.6-3.6 percentage points from a baseline of -1.6 percent). Changes in patient experience scores, readmissions, and emergency department visits were similar for affiliating and nonaffiliating hospitals. While joining health systems may improve rural hospitals' financial performance, affiliation may reduce access to services for patients in rural areas.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Hospitales Rurales
/
Aceptación de la Atención de Salud
/
Indicadores de Calidad de la Atención de Salud
/
Administración Financiera de Hospitales
/
Accesibilidad a los Servicios de Salud
Tipo de estudio:
Health_economic_evaluation
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Health Aff (Millwood)
Año:
2019
Tipo del documento:
Article