Percent of Hospitalized Patients with Covid-19 in Rural vs. Urban Hospitals, U.S. Total. (Source: Rural Hospitals Have Higher Percentages of Patients with Covid-19 than Urban Hospitals (October-December 2020) report.)

The percentage of hospital patients who are being treated for Covid-19 has more than doubled in recent months. And throughout the fall surge in coronavirus cases, rural hospitals have consistently had a greater proportion of patients being treated for Covid-19 than urban hospitals have, a new study shows.

Nationally, the percentage of rural hospital patients who have Covid-19 increased from about 10% during the first week of October to about 25% in late November and early December, the study showed. During the same period, the percentage of urban hospital patients infected with the coronavirus grew from about 6% to 20%.

The trend is primarily affecting hospitals in the Midwest and South, not hospitals in the Northeast or West.

Midwestern states like Wisconsin, North Dakota, South Dakota, Nebraska, and Iowa saw some of the highest rates of new infections during October and November.

The study is based on data from the U.S. Department of Health and Human Services. On December 15, HHS published weekly data on each U.S. hospital tracking key indicators for how the facilities were coping with Covid-19 care. 

The study found that for the last three months, the percentage of patients with Covid-19 has been 4 to 6 percentage points higher in rural areas than in urban ones.

The report says the findings may raise concerns about continued ability of rural hospitals to operate effectively. “Because staffing can be more difficult to maintain in rural hospitals, the higher exposure in rural hospitals may put their staffs – and the hospitals they work in – at greater risk to maintain peak care capacity,” the report says.

(Source: Rural Hospitalizations for COVID-19 Snapshot on December 10, 2020 report)

A second analysis by the N.C. Rural Health Research Program based on a similar set of data found that rural hospitals have a greater percentage of their beds available than urban hospitals, as of December 10. 

Bed availability in rural hospitals ranged from 49% in the Mountain West to 36% in East South Central and West South Central states. 

(The study used Census subdivisions to group states. The Mountain West is composed of Montana, Idaho, Wyoming, Nevada, Utah, Colorado, Arizona, and New Mexico. East South Central states are Kentucky, Tennessee, Mississippi, and Alabama. West South Central States are Oklahoma, Arkansas, Louisiana, and Texas.)

The report says the tighter bed restrictions in urban areas could limit rural residents’ ability to get advanced services if urban hospitals limit or reject transfer patients. Conversely, the greater percentage of open beds in rural hospitals could help urban hospitals expand capacity if rural hospitals accepted transfers of patients with less need for acute care.