Patient Migration Suggests Big Changes Await Rural Hospitals

Nearly half of Tennesseans living in rural areas who seek healthcare drive past the hospitals closest to their homes to look for care in more urban settings, even when their local hospitals offer the same services, a study shows.

The study, Patterns of Care in Tennessee: Use of rural vs. non-rural facilities, from the BlueCross BlueShield of Tennessee Health Institute, explains in great detail the sourcing and methodology used to cull the 2009 data and how it was parsed to get "apples-to-apples" comparisons. For expediency's sake read the original report.

Steven L. Coulter, MD, president of the Health Institute told me the data clearly shows that rural patients are migrating to more urban settings for their healthcare. Coulter also readily concedes that the data can't say why.

"That actually is the question of the hour," says Coulter, an internist. "My speculation is that they perceive, whether true or not, that the services are better elsewhere. We really can't make a policy-level judgment based on the data we have found. All we can say is people are mobile and they are moving. What we can't say is whether that is a good thing or a bad thing, because we haven't looked at clinical outcomes or the economic impact on the communities that these small hospitals serve."