ArticleHealth services research2016
Why Are Obstetric Units in Rural Hospitals Closing Their Doors?
Article in Health services research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 77 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
77 citing papers in PubMed, 1 synthesis or guideline pooled it, 156 citations in OpenAlex.
- Predictors of rural hospital closures in the United States: a systematic review and call for AI-driven early warning systems.BMC health services research · 2025Pooled it
- Risk Factors for Loss of Hospital-Based Obstetric Care in Rural and Urban Hospitals.JAMA health forum · 2026Article
- Rural Versus Urban Distribution of Obstetrics and Gynecology Residency Training and Associated Rural Community Characteristics.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Maternal Geographic Residence and Obstetric Care Access in Relation to Delivery Method Among Individuals With Low-Risk Term Births in the United States.Obstetrics and gynecology · 2026Article
- Spatial and Temporal Trends of Access to Birthing Hospitals in Illinois, 2016-2021.Preventing chronic disease · 2026Article
- Prospective User Perceptions and Acceptability of a Wearable Fetal Heart Monitor: Cross-Sectional Survey.JMIR formative research · 2026Article
- Effect of Hospital Obstetrics Unit Closures on Travel Time to Obstetric Care in the United States.O&G open · 2026Article
- Seasonality, Weather, and Obstetric Level of Care: An Analysis of Rural Delivery Locations.International journal of environmental research and public health · 2026Article
- Strong Obstetric Care Training in Family Medicine Residency: Bolstering the Number of Family Physicians Attending Births.Family medicine · 2026Article
- Planned Community Birth and Birth Outcomes.JAMA pediatrics · 2026Article
- Bridging the Gap: A Mixed-Methods Evaluation of a New Rural Maternity Care Center Amid Nationwide Closures.International journal of environmental research and public health · 2026Article
- Obstetric emergency readiness in rural emergency departments: a cross-sectional survey of birthing and non-birthing hospitals in Montana, USA.BMJ public health · 2026Article
- Reimbursement for Thyroid Surgery and Potential Solutions.JAMA otolaryngology-- head & neck surgery · 2025Article
- Financial challenges of providing obstetric services at rural US hospitals.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Supply-Side Impact of Supporting Obstetrically Underserved Areas: A Nationwide Cross-Sectional Study.Journal of Korean medical science · 2025Article
- Hospital Financial Health and Provision of Obstetric and Neonatal Intensive Care Unit Services.JAMA network open · 2025Article
- Examining perinatal regionalization in practice: a network analysis of maternal transport in Georgia.BMC health services research · 2025Article
- Obstetric care in rural critical access hospitals: A domestic application of the World Health Organization Emergency Obstetric Care framework in rural communities.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Role of general practitioner-led rural community hospitals in Sweden: a qualitative study.BMJ open · 2025Article
- Nurse workforce change and metropolitan medically underserved areas in the United States.BMC health services research · 2025Article
17 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesTo understand hospital- and county-level factors for rural obstetric unit closures, using mixed methods. DATA SOURCES: Hospital discharge data from Healthcare Cost and Utilization Project's Statewide Inpatient Databases, American Hospital Association Annual Survey, and Area Resource File for 2010, as well as 2013-2014 telephone interviews of all 306 rural hospitals in nine states with at least 10 births in 2010. Via interview, we ascertained obstetric unit status, reasons for closures, and postclosure community capacity for prenatal care. STUDY
designMultivariate logistic regression and qualitative analysis were used to identify factors associated with unit closures between 2010 and 2014. PRINCIPAL
findingsExactly 7.2 percent of rural hospitals in the study closed their obstetric units. These units were smaller in size, more likely to be privately owned, and located in communities with lower family income, fewer obstetricians, and fewer family physicians. Prenatal care was still available in 17 of 19 communities, but local women would need to travel an average of 29 additional miles to access intrapartum care.
conclusionsRural obstetric unit closures are more common in smaller hospitals and communities with a limited obstetric workforce. Concerns about continuity of rural maternity care arise for women with local prenatal care but distant intrapartum care.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.