News Media Coverage of Rural Hospital Closures and the Causes
The NC Rural Health Research Program wrote the brief, News Media Coverage of Rural Hospital Closures and the Causes . to augment previous research with findings from a structured framework of attributed causes of closures through the analysis of news media reports. Media reports of closures offer a qualitative dimension that goes beyond numbers, allowing us to understand the deeper context surrounding a hospital closure.
We used closed rural hospital data from the NC Rural Health Research Program’s Rural Hospital Closures database, available on the UNC Sheps Center website. For data collection on the closed hospitals, we conducted primary qualitative content analysis of publicly available media reports. We searched the internet to find media reports on the rural hospital closures. From these media reports extracted keywords describing the cause of closure. We gleaned 70 key words and organized them under the umbrella of 10 groups, or attributed causes of closure (unprofitability, revenue insufficiency, expense burden, low patient volume, demographics, malfeasance and mismanagement, other, consolidation, staffing, and facility and equipment), which are further grouped into three categories of closure (financial causes, patient-related causes, and other causes).
Key Findings:
Financial causes were the most frequently reported reasons for closure of rural hospitals. Unprofitability was cited in over half of the media reports, and revenue insufficiency and expense burden were also frequently reported as causes of rural hospital closures.
Low patient volume and demographics were also reported as major risk factors for rural hospital closures. Low patient volume was cited in over half of the media reports, and adverse demographic trends were also frequently reported as a cause of rural hospital closures.
The causes of rural hospital closures are numerous, complex, and vary by community. Probably the most salient finding from this study is that the causes of rural hospital closures are nuanced and multidimensional.
Hospitals often cited multiple reasons for closure, and every hospital closure presented with a unique set of circumstances. With rural communities being comprised of populations with different characteristics and health care needs, there is no blanket reason for why rural hospitals are closing. However, this brief highlights several risk factors that frequently pertain to the closure of rural hospitals.