Rural hospital closures. Determinants of conversion to an alternative health care facility.

Conversion of closed hospitals to alternative health care facilities is often suggested as a way of maintaining the availability of medical services in rural areas. This study investigates the factors that influence whether or not a closed rural hospital will convert to an alternative health care facility. The study uses primary data collected from a survey of rural hospitals in Texas that closed during the years 1985 through 1990. Regression results indicate that conversion was more likely when the local economy was healthier and when there were fewer substitute forms of health services. Ownership also played a role: government-operated hospitals that closed were less likely to convert than were private not-for-profit providers. The results of the study will be useful for evaluating programs designed to encourage alternative ways to provide health care services in rural areas.