Mobley et. al. examine, in this Rural Policy Brief from the RUPRI Center for Rural Health Policy Analysis, the composition of the local health care workforce before and after rural hospital closure to reveal any associations with discontinuation of inpatient services in rural communities.
Following hospital closure, many rural communities (38.8 percent) saw a decrease in the number of primary care physicians (PCPs). But the majority of communities with a hospital closure (61.2 percent) saw an increase in the number of advanced practice providers (APPs, includes physician assistants and advanced nurse practitioners). In over half (54.5 percent) of the communities where the number of PCPs declined, the number of APPs increased.
Over one-third (37.8 percent) of the communities where the closed hospital was converted to some other type of health care facility saw an increase in the number of PCPs, whereas only 14.6 percent of communities where the hospital building was completely closed saw an increase in the number of PCPs.
In the majority of communities where the number of post-closure PCPs either stayed the same or increased, the number of APPs also increased (58.1 percent and 76.2 percent, respectively).
Although this study only looked at one aspect of rural hospital closure, it is important to note that not every hospital closure looks the same in respect to access to care. The authors state that the above data may reflect the continued presence of primary care service providers in the community and the shift of physician-based care to care provided by APPs.