Increasing Rural Hospital Access by Strategic Facility Placement in North Central Appalachia

Background: There are numerous medical emergencies that require quick treatment, where each minute matters. In rural areas across the United States, health inequalities exist compared to urban areas. Lack of medical access is a disparity. Healthy People 2020 emphasizes the importance of reducing disparity.

Objective/purpose: Hospitals are located near centers of population, however there are rural areas that lack sufficient coverage. This leaves many individuals at risk. One potential method of improving access and reducing disparity is by locating the areas where a facility would benefit the greatest number of individuals.

Methods: Geographic Information Systems (GIS) was used to analyze the greatest number of individuals that would be impacted by strategically placed facilities. This also highlighted areas at greatest risk. Using ESRI’s ArcGIS, a network analysis was performed on data from ESRI, the U.S. Department of Transportation, the CDC, and the U.S. Census Bureau. Analysis showed the radius of transportation time, based on roadways and actual travel time. Areas without adequate coverage were classified based on population to determine where a new facility would have the greatest reach.

Results: Several large areas were found where transportation time to facility reduces health outcomes. Analysis on population clustering illustrated gaps in coverage that could be reached by facilities placed in specific areas.

Discussion/conclusions: Strategically placed facilities could ensure comprehensive and quality care to rural areas, reducing urban/rural health inequalities and reduce cost by ensuring that new facilities have the greatest population reach.