Date of Award


Degree Name

Healthcare Administration


College of Business

Type of Degree


Document Type

Research Paper

First Advisor

Alberto Coustasse


Introduction: Rural hospitals experienced both challenges and opportunities in providing healthcare to the community. As these facilities were one of the largest employers in the area, their impact was significant. Additionally, accessibility to necessary medical services was essential. Thus, sustainability of rural hospitals was vital. In order to assess sustainability, exploration into financial and quality outcomes could help support their ability to thrive.

Purpose of the Study: The purpose of this study was to determine the sustainability of rural hospitals in the U.S. by examining variables that affect these institutions such as accessibility, availability of services, quality outcomes, and effective administrative practices.

Methodology: This qualitative study utilized a literature review and open-ended survey of an expert in Hospital Administration within or collaborating with rural areas. Five databases were used to collect 48 total sources. These sources were reviewed and reduced to 32 sources that were used in the written research. Of these, 17 sources were used in the results section.

Results: The research showed that patient outcomes and mortality rates in rural hospitals fluctuated. However, many rural hospitals offered improvement services or referrals, quality improvement plans for pain management, and quality improvement for end-of-life care. Rural hospitals proved difficulty in maintaining specialties and testing equipment such as a medical ICUs and cardiac intensive care units, neurology, MRI and CT machines, and obstetric services. ROE was more than double in urban as opposed to rural hospitals. However, the state expansion of Medicaid proved profitable for rural hospitals in states that opted to participate.

Discussion/Conclusion: The research demonstrated the sustainability of rural hospitals in the U.S. was multifactorial. The online qualitative survey supported both the vitality of rural hospitals as well as the limited resources and need for partnerships with regional hospitals to promote rural hospital sustainability.


Health services administration.

Health facilities -- Business management.

Rural health services -- United States.

Hospitals, Rural -- United States.