Hospital closures in rural areas disrupt access to care for injured workers but do not significantly increase workers compensation claim costs or disability duration, according to a Workers Compensation Research Institute study released Thursday.
The study examined the impact of hospital closures on access to care and claim outcomes and found that rural hospital closures led to workers traveling an average of 5 miles farther for emergency care services and a 3.6 percentage point decline in the use of emergency care services after work-related injuries.
Among workers already farther from hospitals, emergency care use dropped by more than 10 percentage points, according to the Waltham, Massachusetts-based organization.
Researchers said the care did not disappear but shifted to other settings, with increases in office visits, physical medicine services and major surgery services delivered outside hospitals. Workers also traveled farther for evaluation and management services, though there was little change in how quickly they received initial medical care.
“Because there are few alternatives when a hospital closes, rural workers travel longer to another hospital, and in many rural areas, patients already travel long and far to receive specialty care even before a hospital closure,” the report said.
Despite those disruptions, the study found little effect on specialty service use, medical payments per claim, indemnity payments per claim or the duration of temporary disability benefits. Researchers concluded that hospital closures primarily change where care is delivered rather than whether workers ultimately receive treatment.
The report found urban hospital closures had more limited effects on access to care and claim outcomes than closures in rural areas. Researchers used workers compensation claims data to compare outcomes for injured workers living near closed hospitals with those in areas where the three nearest hospitals remained open.
The WCRI said the findings suggest hospital closures are more disruptive to access than to overall claim costs, indicating workers compensation systems may absorb the operational effects even as injured employees face longer travel times and shifts in where they receive care.
This article was first published in Business Insurance
