Rural Orthopaedics: Not for the Faint of Heart

Rural hospitals are struggling, but innovative solutions can be found

K. William Kumler, MD, MBA; Craig Mahoney, MD; and Michael Suk, MD, JD, MPH

Although hospital closures have been relatively uncommon in the United States, the rate of rural hospital closures has increased dramatically in the wake of the Affordable Care Act (ACA)—from 3 in 2010 to 16 in 2014. Of the nearly 50 rural hospitals that closed between 2010 and 2014, all but 8 had fewer than 50 beds. In many rural settings, patients lose their “golden hour”—that period when medical treatment after a traumatic injury may be lifesaving—simply getting to the closest facility.

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