911 Emergency: Rural Hospitals

Don't forget to tune in for the live text-chat with Problem Author Dr. Paul Taylor in the "Comments" section below!

Rural hospitals in the United States are in crisis. 83 have closed in the past 8 years. A number of factors are squeezing the finances of rural hospitals. Populations in many rural communities are shrinking while also becoming older and poorer. Facilities are aging and there is no money to renovate and install new technologies. When a hospital closes, not only is access to medical care greatly reduced, the loss of jobs and foot traffic devastates the community.

Georgia has been hit particularly hard, losing six rural hospitals since 2010. A strategy must be devised to provide a reasonable level of medical access to rural residents.

  1. Build a model to estimate the number of hospitals necessary to provide at least one hospital within a 30 minute drive of any location within the state of Georgia.
  2. The most expensive unit of a hospital is the emergency room. Not only does it require 24 hour staffing, but patients without health insurance must be treated, often resulting in financial losses for the hospital. Since only 7.9% of emergency room visits result in hospital admission (and only 1.3% are critical (CDC.gov)), it’s possible that sparsely populated rural communities might be well-served by clinics which provided non-emergency care.  In critical cases, ambulances would be needed to transport patients to the nearest hospital. Build a model that determines how many hospitals, how many clinics, and how many ambulance locations would be needed in the state of Georgia to guarantee that patients in critical condition could be transported from their home to a hospital within 1 hour.
  3. Does the strategy of replacing unprofitable hospitals with clinics and ambulance service save money while still providing a reasonable level of medical care access? Are there alternative strategies which perform better? Use modeling to provide insight. For example, one of the articles linked below discusses the option of freestanding emergency departments (ruralhealthresearch.org).

The following references may help you get started:

Articles on the rural hospital closure issue:

Papers regarding rural hospital costs:

Georgia population distribution:

Additional hospital data:

Problem author: Dr. Paul Taylor, Shippensburg University