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Utilization of Hospital Services among Older Rural Persons: A Comparison of Critical Access Hospitals and Community Hospitals

Author: BRIAN K. COLLINS and TYRONE F. BORDERS
Published in JHHSA, Vol. 28 No. 1

Critical access hospitals (CAHs) are intended to improve the
accessibility of local emergency and short-term inpatient services, but
limited research has evaluated their effects on hospital service
utilization. This article asks whether the utilization of hospital and
emergency room services differs between older persons residing in
rural areas with a CAH versus a community hospital. Information about
the utilization of hospital and emergency room services as well as
demographic, health insurance, and health status factors were
abstracted from a large population-based survey of community-
dwelling elders (age 65 and older) residing in West Texas. The
frequencies of hospital inpatient and emergency department admission
do not differ between older persons who reside in counties with a CAH
and a community hospital. These findings support the broad goals of
the program and illustrate how Medicare can effectively support
healthcare systems under fiscal stress.

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