Impact of Rural and Urban Hospital Closures on Inpatient Mortality / Kritee Gujral, Anirban Basu.

Format:

Book

Author/Creator:

Gujral, Kritee.

Contributor:

National Bureau of Economic Research.

Basu, Anirban.

Series:

Working Paper Series (National Bureau of Economic Research) no. w26182.

NBER working paper series no. w26182

Language:

English

Physical Description:

1 online resource: illustrations (black and white);

Place of Publication:

Cambridge, Mass. National Bureau of Economic Research 2019.

Summary:

This paper uses a difference-in-difference approach to examine the impact of California's hospital closures occurring from 1995-2011 on adjusted inpatient mortality for time-sensitive conditions: sepsis, stroke, asthma/chronic obstructive pulmonary disease (COPD) and acute myocardial infarction (AMI). Outcomes of admissions in hospital service areas (HSAs) with and without closure(s) are compared before and after the closure year. The paper focuses on: 1) the <i>differential</i> impacts of rural and urban closures, 2) the aggregate patient-level impact across several post-closure mechanisms, and 3) the effect on Medicare as well as non-Medicare patients. Results suggest that when treatment groups are not differentiated by hospital rurality, closures appear to have no measurable impact, i.e. there is no <i>general</i> impact of closures. However, estimating <i>differential</i> impacts shows that rural closures increase inpatient mortality by 0.78% points (an increase of 8.7%), whereas urban closures have no measurable impact. Subgroup analyses indicate the existence of a <i>general</i> impact for stroke and AMI patients (4.4% increase in inpatient mortality) and relatively worse impacts of rural closures for Medicaid patients and racial minorities (11.3% and 12.6%, respectively).

Notes:

Print version record

August 2019.