Changes in service offerings post-system affiliation in rural hospitals
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Rural policy brief
- Author(s):
- Oyeka, Onyinye, author Ullrich, Fred, (Public health researcher) author Shane, Dan, author Mueller, Keith J., 1951- author
- Contributor(s):
- RUPRI Center for Rural Health Policy Analysis, issuing body. Rural Health Research & Policy Centers, issuing body. Rural Policy Research Institute (U.S.), issuing body.
- Publication:
- Iowa City, IA : Rural Policy Research Institute, January 2023
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Hospitals, Rural -- organization & administration Organizational Affiliation Rural Health Services United States
- Genre(s):
- Technical Report
- Abstract:
- Affiliations between rural hospitals and regional and national health systems have increased from 10 to 30 per year in the 2000s to approximately 30 to 70 per year in the 2010s. Rural hospital leaders have indicated that hospital affiliation with a regional or national system can result in substantial benefits through access to capital investments. Benefits may include updating systems and equipment, reducing costs through clinical process standardization, improving access to specialists, and adding service lines. However, affiliation may negatively affect rural hospitals and patients if it leads to higher prices, rural hospital closure, or eliminating essential health care services and service lines. Prior research evaluating the impact of system affiliation in rural hospitals often focused on the financial performance, cost, quality, and service utilization in these hospitals post-affiliation. There is limited research on what happens to hospital services in communities after the local hospital enters into system affiliation. One recent study reported reduced service availability in rural hospitals following system affiliation. However, that study focused on a limited set of service offerings. System affiliation may lead to an increase or decline in the number of services offered in the local hospital. This may have positive or negative effects for patients and may change both access to care and quality of care. Plausible mechanisms for these effects include hospital systems’ decisions to align services and resources such that areas of clinical excellence and cost performance across member hospitals are optimized and decisions to maintain or augment local access to services based on the need for frequent patient contact or a need to move low-acuity cases out of tertiary and quaternary care facilities. In these instances, primary care and telemedicine service offerings may increase. This policy brief aims to understand the range of effects on service offerings after rural hospitals become part of, or leave, a regional or national health care system. This analysis does not evaluate patient-level access to care and does not assign a positive or negative value to services gained or lost.
- Copyright:
- The National Library of Medicine believes this item to be in the public domain. (More information)
- Extent:
- 1 online resource (1 PDF file (13 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918715986406676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918715986406676