RESUMO
BACKGROUND: We wanted to assess whether a regional approach to bed management and staffing could improve financial sustainability without reducing services in rural communities. METHODS: Regional approaches to patient placement, hospital throughput, and staffing were coupled with enhanced services at 1 hub hospital and 4 critical access hospitals. RESULTS: We improved the use of patient beds in the 4 critical access hospitals, increased hub hospital capacity, and improved the health system's financial performance while maintaining or enhancing services at the critical access hospitals. DISCUSSION: Sustainability of critical access hospitals can be attained without a decrease in services for rural patients and communities. One way to achieve this result is to invest in and enhance care at the rural site.
