Original Paper

Journal of Medical Systems

, Volume 32, Issue 4, pp 343-353

First online:

Determinants of Hospital Choice of Rural Hospital Patients: The Impact of Networks, Service Scopes, and Market Competition

  • Chul-Young RohAffiliated withDepartment of Public Health, College of Public and Allied Health, East Tennessee State University
  • , Keon-Hyung LeeAffiliated withAskew School of Public Administration and Policy, Florida State University Email author 
  • , Myron D. FottlerAffiliated withDepartment of Health Professions, 210A HPA 2, College of Health and Public Affairs, University of Central Florida

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Among 10,384 rural Colorado female patients who received MDC 14 (obstetric services) from 2000 to 2003, 6,615 (63.7%) were admitted to their local rural hospitals; 1,654 (15.9%) were admitted to other rural hospitals; and 2,115 (20.4%) traveled to urban hospitals for inpatient services. This study is to examine how network participation, service scopes, and market competition influences rural women’s choice of hospital for their obstetric care. A conditional logistic regression analysis was used. The network participation (p < 0.01), the number of services offered (p < 0.05), and the hospital market competition had a positive and significant relationship with patients’ choice to receive obstetric care. That is, rural patients prefer to receive care from a hospital that participates in a network, that provides more number of services, and that has a greater market share (i.e., a lower level of market competition) in their locality. Rural hospitals could actively increase their competitiveness and market share by increasing the number of health care services provided and seeking to network with other hospitals.


Hospital choice Hospital competition Conditional logistic regression Rural hospitals