Rural Hospitals Experienced More Patient Volume Variability Than Urban Hospitals During The COVID-19 Pandemic, 2020–21

• DOI: 10.1377/hlthaff.2023.00678
• Publication Date: 2024-05-06T19:51:42Z
• Authors: H. Joanna Jiang; Rachel Mosher Henke; Kathryn R. Fingar; Lan Liang; Denis Agniel; Marc I. Roemer
• Keywords: Pandemic; 2019-20 coronavirus outbreak; Betacoronavirus

Fluctuations in patient volume during the COVID-19 pandemic may have been particularly concerning for rural hospitals. We examined hospital discharge data from Healthcare Cost and Utilization Project State Inpatient Databases to compare period (March 8, 2020–December 31, 2021) with prepandemic (January 1, 2017–March 7, 2020). Changes average daily medical at hospitals showed a dose-response relationship community burden, ranging 13.2 percent decrease periods of low transmission 16.5 increase high transmission. Overall, about 35 experienced fluctuations exceeding 20 (in either direction) total volume, contrast only 13 urban experiencing similar magnitudes changes. Rural large change were more likely be smaller, government-owned, critical access significantly lower operating margins. Our findings suggest that vulnerable operationally financially shifts pandemic, which warrants attention because potential impact on these hospitals' long-term sustainability.