The Effect of Rural Hospital Closure on the Local Clinician Population

In rural areas where access to health care is low and rates of chronic illness are high, hospitals are closing at an alarming rate. 148 rural hospitals have closed since 2010, which has recently prompted Congress to introduce the Rural Hospital Closure Relief Act of 2023. As research has looked both at the economic and community health impacts of these closures, I direct my attention to the impact on health care providers. The primary goal of this study is to estimate the causal effect of rural hospital closures on the number of clinicians practicing in a given ZIP code. I examine a sample of 41 U.S. ZIP codes with a rural hospital closure between 2017 and 2019. ZIP codes after rural hospital closure have a reduction of 28.30 clinicians on average within the post-closure timeframe, reaching a maximum reduction of 50.53 clinicians on average at 2 years post-closure. In analyzing the differential effects of clinician specialty, the treatment effect for specialized care clinicians is 12.57 greater than primary care clinicians, suggesting that specialized providers may be more sensitive to push factors associated with rural hospital closure.