This article examines both the direct and the spillover effects of hospital ownership on the availability of medical services in rural areas. The authors assess for-profit and nonprofit market share in rural areas and identify differences in characteristics of geographic areas, like population density. Using regression analysis, they identified the direct effects and spillover effects of rural hospital ownership and offering.
Included in this study are all nonfederal, general medical and surgical hospitals falling outside of metropolitan statistical areas (MSA); data used are from 1988 to 2005 and from the American Hospital Association, U.S. Census, CMS Healthcare Cost Report Information System and Prospective Payment System Minimum Data File and primary data collection for geographic coordinates.
In policy development, hospital ownership ought to be considered in broader term than their effect on nonprofit hospital behavior. Mixed-ownership markets and competition must be better understood.