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Do patients bypass rural hospitals? Determinants of inpatient hospital choice in rural California

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  • José J. Escarce
  • Kanika Kapur

Abstract

Rural hospitals play a crucial role in providing healthcare to rural Americans, a vulnerable and underserved population; however, rural hospitals have faced threats to their financial viability and many have closed as a result. This paper examines the hospital characteristics that are associated with patients choosing rural hospitals, and sheds light on the types of patients who depend on rural hospitals for care and, hence, may be the most impaired by the closure of rural hospitals. Using data from California hospitals, the paper shows that patients were more likely to choose nearby hospitals, larger hospitals, and hospitals that offered more services and technologies. However, even after adjusting for these factors, patients had a propensity to bypass rural hospitals in favor of large urban hospitals. Offering additional services and technologies would increase the share of rural residents choosing rural hospitals only slightly.

Suggested Citation

  • José J. Escarce & Kanika Kapur, 2009. "Do patients bypass rural hospitals? Determinants of inpatient hospital choice in rural California," Working Papers 200902, School of Economics, University College Dublin.
    • Handle: RePEc:ucn:wpaper:200902
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    File URL: http://hdl.handle.net/10197/1007
    File Function: First version, 2009
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    References listed on IDEAS

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    1. Eberhardt, M.S. & Pamuk, E.R., 2004. "The importance of place of residence: Examining health in rural and nonrural areas," American Journal of Public Health, American Public Health Association, vol. 94(10), pages 1682-1686.
    2. Liu, Liyan & Hader, Joanne & Brossart, Bonnie & White, Robin & Lewis, Steven, 2001. "Impact of rural hospital closures in Saskatchewan, Canada," Social Science & Medicine, Elsevier, vol. 52(12), pages 1793-1804, June.
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    Cited by:

    1. Onder, O. & Cook, W. & Kristal, M., 2022. "Does quality help the financial viability of hospitals? A data envelopment analysis approach," Socio-Economic Planning Sciences, Elsevier, vol. 79(C).
    2. Abdullah Alibrahim & Shinyi Wu, 2018. "An agent-based simulation model of patient choice of health care providers in accountable care organizations," Health Care Management Science, Springer, vol. 21(1), pages 131-143, March.
    3. Yun Liu & Qingxia Kong & Shasha Yuan & Joris van de Klundert, 2018. "Factors influencing choice of health system access level in China: A systematic review," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-21, August.

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