ArticleHealth affairs scholar2025
Changes in surgical quality and access after rural hospital closures.
Article in Health affairs scholar, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 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
6 citing papers in PubMed.
- Cancer Surgery Outcomes After Implementation of a Global Budget Model in Rural Hospitals.Annals of surgery · 2026Article
- Rural Residence and Postsurgical Outcomes Among Medicare Beneficiaries.JAMA network open · 2026Article
- Surgical Outcomes and Postacute Care Use Among Rural Medicare Advantage Beneficiaries.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Disparities Across Race, Ethnicity, and Rurality Among Surgical Patients.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Trauma and emergency surgical care at rural emergency hospital-eligible facilities: Interstate variation and policy implications for rural health systems.The journal of trauma and acute care surgery · 2026Article
- A readiness framework for tele-robotic surgery deployment in rural hospitals.Journal of robotic surgery · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
There are rising concerns about the effects of rural hospital closure on access to and quality of care for impacted patients, but little remains known about surgical care. The objective of this study was to evaluate the association of hospital closure with outcomes and access to surgery for common surgical conditions. Using Medicare claims data from 2010-2020, we evaluated the impact of rural hospital closures on surgical quality and access for common operations (colectomy, cholecystectomy, appendectomy, and hernia repair). Using a dynamic difference-in-differences approach, we analyzed 36 884 and 41 185 beneficiaries who lost their nearest and second-nearest rural hospital, respectively. Our findings revealed no significant impacts on surgical quality as measured by 30-day mortality, complications, serious complications, reoperations, and readmissions. While rates of unplanned surgery did not change, median travel distance increased from 13.1 to 16.4 miles for beneficiaries who lost their nearest hospital but was unchanged for those losing their second-nearest hospital. These findings suggest that, while rural hospital closure does not adversely impact surgical quality, it does pose challenges in ensuring access to timely surgical care. Policymakers should consider tailored interventions to mitigate the persistent and growing travel disparities to obtain care in rural America.
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Registered trials
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