Abstract
Critical access hospitals (CAHs) are intended to improve the accessibility of local emergency and short-term inpatient services, but limited research has evaluated their effects on hospital service utilization. This article asks whether the utilization of hospital and emergency room services differs between older persons residing in rural areas with a CAH versus a community hospital. Information about the utilization of hospital and emergency room services as well as demographic, health insurance, and health status factors were abstracted from a large population-based survey of community-dwelling elders (age 65 and older) residing in West Texas. The frequencies of hospital inpatient and emergency department admission do not differ between older persons who reside in counties with a CAH and a community hospital. These findings support the broad goals of the program and illustrate how Medicare can effectively support healthcare systems under fiscal stress.