Barr, Kanlaya Jintanakul; Otto, Daniel

Review of Regional Studies Vol. 39 no. 2 (Fall 2009): 171-187.

This study uses Iowa Hospital Association records related to inpatient and outpatient procedures performed at rural Iowa hospitals to examine how institutional, location, and individual characteristics affect choice of hospitals for rural residents. The rural residents most likely to bypass their local hospitals are younger people with private outpatient insurance already living a long distance from any hospital. Complex procedures and life-threatening illnesses can reduce the probability of choosing the nearest rural hospital. Rural residents also appear less likely to bypass the nearest rural hospital for outpatient services.

JEL Classification: H44, I11, R12

Keywords: rural hospitals, spatial, GIS, bypassing