ArticleInquiry : a journal of medical care organization, provision and financing
Rural Hospital Mergers Increased Between 2005 and 2016-What Did Those Hospitals Look Like?
Article in Inquiry : a journal of medical care organization, provision and financing. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
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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.
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Who cites it
13 citing papers in PubMed.
- Community Characteristics Associated With Health System Penetration.Medical care research and review : MCRR · 2026Article
- The Impact of Rural Hospital Closures and Mergers on Health System Ecologies: A Scoping Review.Medical care research and review : MCRR · 2025Article
- Service Changes, Utilization, and Financial Performance After Critical Access Hospitals Join Hospital Systems.Cureus · 2025Article
- Rural nonprofit hospital community benefit and financial assistance spending: A call for greater reporting transparency.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Health System Integration and Cancer Center Access for Rural Hospitals.The American surgeon · 2024Article
- Structural Factors and Racial/Ethnic Inequities in Travel Times to Acute Care Hospitals in the Rural US South, 2007-2018.The Milbank quarterly · 2023Article
- Text Analysis of Trends in Health Equity and Disparities From the Internal Revenue Service Tax Documentation Submitted by US Nonprofit Hospitals Between 2010 and 2019: Exploratory Study.Journal of medical Internet research · 2023Article
- Impact of merging two university hospitals on surgical outcome after esophagogastric and hepato-pancreato-biliary surgery: Results from a retrospective study.Surgery open science · 2023Article
- Is patients' rurality associated with in-hospital sepsis death in US hospitals?Frontiers in public health · 2023Article
- Reimagining and reinvesting in rural hospital markets.Health services research · 2022Article
- Risk of Closure Among Independent and Multihospital-Affiliated Rural Hospitals.JAMA health forum · 2022Article
- Medicaid Expansion Alone Not Associated With Improved Finances, Staffing, Or Quality At Critical Access Hospitals.Health affairs (Project Hope) · 2021Article
- Administration of Strategic Agreements in Public Hospitals: Considerations to Enhance the Quality and Sustainability of Mergers and Acquisitions.International journal of environmental research and public health · 2021Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
The objective of this study is to determine whether key hospital-level financial and market characteristics are associated with whether rural hospitals merge. Hospital merger status was derived from proprietary Irving Levin Associates data for 2005 through 2016 and hospital-level characteristics from HCRIS, CMS Impact File Hospital Inpatient Prospective Payment System, Hospital MSA file, AHRF, and U.S. Census data for 2004 through 2016. A discrete-time hazard analysis using generalized estimating equations was used to determine whether factors were associated with merging between 2005 and 2016. Factors included measures of profitability, operational efficiency, capital structure, utilization, and market competitiveness. Between 2005 and 2016, 11% (n = 326) of rural hospitals were involved in at least one merger. Rural hospital mergers have increased in recent years, with more than two-thirds (n = 261) occurring after 2011. The types of rural hospitals that merged during the sample period differed from nonmerged rural hospitals. Rural hospitals with higher odds of merging were less profitable, for-profit, larger, and were less likely to be able to cover current debt. Additional factors associated with higher odds of merging were reporting older plant age, not providing obstetrics, being closer to the nearest large hospital, and not being in the West region. By quantifying the hazard of characteristics associated with whether rural hospitals merged between 2005 and 2016, these findings suggest it is possible to determine leading indicators of rural mergers. This work may serve as a foundation for future research to determine the impact of mergers on rural hospitals.
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