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US Hospitals in Rural Areas
ONC Editorial

Feb 24, 2023

In this article, the importance of making medical care in America more accessible and affordable is discussed. (The opinions expressed in this piece are those of the individual author, whose information can be found below.)

The United States hospital system has faced its fair share of scrutiny for many reasons, one of the most common being inequities between the quality and proximity of hospitals to patients. One of the foremost examples of this is the lack of hospitals and smaller-scale medical clinics in predominantly rural areas. 

There are many factors that have led to this predicament. First, a disproportionate population to hospital ratio in suburban and urban areas have resulted in consolidation. This can be attributed to lost revenue and lack of demand needed to sustain normal capacity, as hospitals in more populated areas also serve as facilities for specialized medical practices and procedures. Because of this, most rural residents are forced to travel far distances in order to receive the treatment they require, sometimes traveling hundreds of miles from their homes. According to one study published in the Healthcare Finance Review, rural patients experience a 28% increase in admissions to urban hospitals and substantial increases in admissions to teaching hospitals and rural referral centers. This has the potential to lead to significant cost implications, as these institutions generally receive higher Medicare reimbursement.

There are also many other barriers that could hinder a patient from accessing a hospital in rural areas. For example, a lack of public transportation has greatly impacted rural citizens, as this leaves driving to be the only option available for reaching hospitals or any other forms of medical care. To make matters worse, extreme weather conditions and hazardous roads can make a long journey perilous, and this fact alone could prevent someone from getting the urgent medical assistance they need.

In order to mitigate the medical disparities that rural residents face, governmental institutions could build hospitals in areas that are spaced proportionately. Another solution would be to create more reliable public transportation, which could give residents an alternate form of transit to hospitals, if they don’t have the option of using a car. One way to attract new doctors to rural hospitals could be to offer reduced tuition for medical school if they choose to relocate to a rural area and serve in the associated medical facilities. This would, by no means, solve the issue of supplying staff for rural hospitals, but it may mitigate the potential shortage of newly-trained doctors and physicians. Every American should have the right to affordable and accessible medical care, regardless if they reside in cities, suburbs or in the countryside. 

Christian Williams was an Infrastructure intern at Our National Conversation prior to our Fall 2021 semester. 


“Building Better Public Transit in Rural America.” Ridewithvia.com, Via Transportation, Inc., 23 Oct. 2020, https://ridewithvia.com/resources/articles/building-better-public-transit-in-rural-america/#:~:text=As%20the%20US%20Department%20of,five%20Americans%20who%20live%20in.

Kowarski, Ilana. “Why Is It So Hard to Get Into Medical School?” U.S. News & World Report, U.S. News & World Report L.P., 30 Mar. 2022, https://www.usnews.com/education/best-graduate-schools/top-medical-schools/articles/2018-12-03/why-its-hard-to-get-into-medical-school-despite-doctor-shortages.

National Conference of State Legislatures, https://www.ncsl.org/blog/2019/12/18/the-health-care-worker-hospital-shortage-in-rural-america.aspx. 

Rogan, Erika, and Joy Lewis. “Rural Health Care: Big Challenges Require Big Solutions.” American Hospital Association | AHA News, American Hospital Association, 28 Jan. 2020, https://www.aha.org/news/insights-and-analysis/2020-01-28-rural-health-care-big-challenges-require-big-solutions.

Stanford Medicine, https://med.stanford.edu/ruralhealth/health-pros/factsheets/disparities-barriers.html. 

Warshaw, Robin. “Health Disparities Affect Millions in Rural U.S. Communities.” Association of American Medical Colleges, AAMC, 31 Oct. 2017, https://www.aamc.org/news-insights/health-disparities-affect-millions-rural-us-communities. 

Weisgrau, S. “Issues in rural health: access, hospitals, and reform.” Health care financing review vol. 17,1 (1995): 1-14.

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