Serious concerns over whether our health care delivery systems are ready to respond to bioterrorist attacks and other emergencies have been raised following the events of September 11, 2001. Public funding to address health care concerns related to homeland security has increased considerably at federal, state, and local levels, and health care providers - including physicians and institutional providers - have become part of the dialogue on readiness for bioterrorist and terrorist attacks. The role of the hospital as a focal point in planning is receiving considerable attention. At the same time, special concerns and issues pertain to the rural hospital. Rural hospitals may certainly be expected to provide emergency care resorting from bioterrorist attacks and will likely serve as points from which patients would be transferred. However, there are opportunity costs of defining, implementing, and maintaining rural hospital emergency preparedness. This cost will be very real to rural hospitals, which tend to be smaller in size and generate more limited revenues than urban hospitals.

The purpose of this study was to improve our understanding of rural Emergency Room (ER) capacity and the nature of constraints in expanding capacity in response to demand surge caused by emergencies, including acts of terrorism or bioterrorism. Specific issues that were investigated include:

• ER capacity and surge capacity in rural hospitals
  
• Constraints on this capacity, including workforce and equipment and supply concerns
• Current emergency preparedness planning of rural hospitals for surges
• Whether emergency preparedness plans specifically address bioterrorism and related workforce training needs

These issues were investigated using a comprehensive review of the literature, discussions with hospital administrators, and an expert panel discussion.

Related Products

Schur, C., Berk, M. and Mueller, C. 2004. "Perspectives of Rural Hospitals on Bioterrorism Preparedness Planning." NORC Walsh Center for Rural Health Analysis Policy Brief.  W Series, No. 4. April.  (354K)

Schur, C. 2004. "Understanding The Role Of The Rural Hospital Emergency Department In Responding To Bioterrorist Attacks And Other Emergencies: A Review Of The Literature And Guide To The Issues." Report to the Federal Office of Rural Health Policy. April.  (139K)