Some potential points to spur discussion:

  • Hospitals establishments do not tend to cluster together in high frequencies, but rather are able to scale up to deal with higher local demand.
  • However, counties can present structural as well as economic barriers to hospitals seeking to locate there. For example, the presence of potential patients may not be enough to remain a viable business. Instead these establishments may require an additional location specific feature such as a highly skilled labor force, a high per capita income, or a high share of residents with financial access to health care to sustain a viable business.
  • Due to this (and other reasons), hospitals are less likely to locate in rural counties and tend to locate in greater number in urban adjacent counties relative to urban counties.
  • Hospitals often locate on the edge of large central places near large transportation/highway nexuses for cheaper land and to maximize their market size through a larger market radius.
  • Generally, higher shares of insured residents, increase the likelihood of a there being a hospital, though large shares of Medicaid patients can reduce the likelihood.

For the detailed journal article from which this map derives, see Van Sandt, Anders, Craig Wesley Carpenter, Rebekka Dudensing, and Scott Loveridge. 2021. “Estimating Determinants of Healthcare Establishment Locations with Restricted Federal Administrative Data.” Under review.

This project was supported by the Agricultural and Food Research Initiative Competitive Program of the USDA National Institute of Food and Agriculture (NIFA), award number 2017-67023-26242.


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