Trends in the Provision of Surgery by Rural Hospitals

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Background of “Trends in the Provision of Surgery by Rural Hospitals”

Surgery is an important health service in rural communities. In addition to providing routine surgical services, surgeons also serve as backup for other medical specialities such as obstetrics and are essential for the treatment of many emergency and trauma patients. Surgery provision also affects the financial viability of local hospitals and the economic well-being of rural communities. For many rural hospitals, surgery is an important source of revenue and a major contributor to profitability.1 This findings brief describes trends in the provision of surgery by rural hospitals.

Key Findings:

• The number of rural hospitals that did not provide surgery increased between 2001 and 2008.
• Between 2001 and 2008, hospitals located in metropolitan and micropolitan locations were more likely to provide surgery than hospitals located in non-core based statistical area (non-CBSA) counties (those counties that were not metropolitan or micropolitan).
• In 2008, most of the rural hospitals that reported no surgery charges were Critical Access Hospitals (CAHs). Across rural hospitals, CAHs had the lowest percent of their total charges attributable to surgery. More than one half of the total surgery charges for all rural hospitals were reported by Rural Referral Centers.
• The provision of surgical services may have migrated from rural hospitals with relatively lower or no surgery volume to hospitals with relatively higher surgery volume.