THE COMPOSITION OF RURAL HOSPITAL MEDICAL STAFFS - THE INFLUENCE OF HOSPITAL NEIGHBORS

The local supply of physicians has a strong influence on the availabil ity and the quality of services provided by rural hospitals. Neverthel ess, there are no published studies that describe the composition of r ural hospital medical staffs and, in particular, the availability of s pecialists on these staffs. This study uses 1991 and 1994 survey data from rural hospitals located in eight states to describe the specialty composition and factors that influence the presence of specialists on rural hospital medical staffs. The results show a strong, positive as sociation between the level of medical staff specialization in rural h ospitals and the level of medical specialization of their closest rura l neighbors, which suggests there is competition among rural hospitals based on the composition of the hospital medical staff. Analysis by s pecialty type, however, indicates that the degree of competition may d iffer for different types of specialists.