Nearby, but not wanted? The bypassing of rural hospitals and policy implications for rural health care systems

This study examines the underutilization of rural hospitals. The authors study hospital and patient characteristics to determine why and how rural patients bypass local rural hospitals despite the availability of comparable medical services. The general conditional logit analysis of data on patients and hospitals suggests that hospital characteristics (size, ownership, and distance) and patient characteristics (payment source, medical condition, age, and race) influence rural patients' decisions to bypass local rural hospitals. The study offers two suggestions (policy implications) to better utilize rural health care institutions: a market-centered approach, and more effective government intervention for horizontal and vertical hospital integration.