How far is too far? Rural hospital closures and emergency room travel distances

In the past decade, rural hospital closures have been occurring at an increasing pace. This paper explores historical key health policies that resulted in hospital bed growth over the past 75 years and the subsequent factors that have resulted in hospital closures, particularly in rural locations. These closures have reduced the number of licensed hospital emergency rooms available in rural locations and have resulted in new challenges for emergency medical service providers attempting to transport rural residents over increased distances for emergency care. Today’s healthcare literature does an excellent job of documenting the increased rate of rural hospital closures and explores the subsequent increases in emergency room travel distances and access issues for emergency services consumers living in rural areas that have experienced hospital closures. This paper examines hospital emergency room closures from 2014 to 2023 in rural Missouri. The paper then goes beyond a retrospective review of closed rural Missouri hospitals and mapping of hospital locations to establish a process for identifying rural Missouri hospitals at risk of closure in 2024 and beyond, mapping the potential impact on emergency room travel distances should these hospital closures actually occur. The model presented in the research is designed to be easily utilised by regional health planners, helping them to identify potential hospital closures and communicate the potential healthcare access impact to community stakeholders.