A sweeping national study tracking a decade of hospital operations found that closures of facilities offering surgical care significantly outpaced the opening of new ones, creating a net loss of nearly 300 hospitals across the United States. These shutdowns were not evenly distributed, as the research revealed they were overwhelmingly concentrated in socioeconomically disadvantaged communities, threatening to deepen existing health care disparities for the nation’s most vulnerable populations.
The findings, presented at the American College of Surgeons Clinical Congress 2025, paint a stark picture of diminishing access to essential medical services. By analyzing federal data from 2010 to 2020, researchers quantified a trend that strains regional health systems and disproportionately harms residents in areas with high poverty and social vulnerability. The loss of these facilities means millions of Americans face longer travel times for critical care, and the remaining hospitals must absorb a sudden influx of patients, placing significant stress on their emergency and surgical departments.
A Decade of Shrinking Access
The comprehensive analysis examined all U.S. hospitals performing at least 100 operations annually over the study period. In 2010, 4,688 such facilities were active. By 2020, 784 of those hospitals, or 16.7%, had closed their doors. During the same 10-year span, only 486 new hospitals capable of providing surgical care opened, resulting in a net decrease of 298 facilities nationwide, a reduction of more than 6%. This decline represents a significant contraction in the physical infrastructure available for delivering surgical services across the country.
This trend directly translated into reduced geographic access for patients. The study calculated that the number of areas within a 15-minute drive of a surgical hospital fell by 6.2%. The loss was still apparent when extending the radius, with a 3.7% decrease in areas within a 30-minute drive of such a facility. These figures illustrate a tangible increase in the distance and time many Americans must now travel to receive necessary surgical care, a barrier that can have critical consequences in emergency situations and for routine procedures alike.
Identifying Vulnerable Communities
To understand the socioeconomic dimension of these closures, the researchers correlated hospital data with community-level demographics. The primary source for hospital information was the American Hospital Association (AHA), which provides annual survey data on the status and services of medical facilities. This allowed the team to track the opening, closure, and ongoing operation of thousands of hospitals over the ten-year period.
For community characteristics, the study employed the Social Vulnerability Index (SVI) from the Centers for Disease Control and Prevention (CDC). The SVI is a powerful tool that uses U.S. Census data to identify communities that may need the most support before, during, and after public health emergencies or disasters. It ranks census tracts on 15 social factors, including poverty, unemployment, minority status, and housing type, to create a composite score of social vulnerability. By mapping the SVI scores of the census tracts where hospitals closed, opened, or remained active, the researchers could directly compare the socioeconomic landscapes of these areas.
The Disproportionate Impact
The study’s central finding was the stark disparity between the communities that lost hospitals and those that retained or gained them. According to the analysis, hospitals that closed were more than twice as likely to be located in areas with high levels of poverty and social vulnerability compared to hospitals that remained open. The census tracts where hospitals shut down consistently showed lower median incomes and higher scores on the Social Vulnerability Index.
This pattern indicates that the contraction of surgical infrastructure is not a random process but one that selectively disadvantages already struggling communities. The loss of a local hospital in a low-income area removes a critical lifeline for residents who may already face barriers to care, such as a lack of reliable transportation, inflexible work schedules, or insufficient insurance coverage. The closure exacerbates these challenges, forcing patients to navigate more complex and costly logistical hurdles to reach the next-nearest facility.
Consequences for Patients and Health Systems
The effects of a hospital closure ripple throughout the entire regional health care ecosystem. For patients, the most immediate consequence is a loss of timely access to care. For health systems, the impact is a sudden and often overwhelming surge in demand at the remaining facilities. According to the study authors, the closure of a single hospital creates a “huge influx of patients to surrounding hospitals, straining the emergency departments and surgical departments.”
This increased load can lead to longer wait times, overcrowded emergency rooms, and a greater potential for delayed or rescheduled surgeries. The added strain can also compromise the quality of care and lead to burnout among medical staff. Jesse E. Passman, MD, MPH, MSHP, the study’s lead author and a general surgery resident at the Hospital of the University of Pennsylvania, noted the sheer scale of the trend was surprising. The data shows a systemic problem where the burden of a shrinking health care landscape is shifted onto a smaller number of remaining hospitals, which themselves may already be operating at capacity.
Context of the National Study
The research provides a critical, data-driven perspective on the ongoing consolidation and closure of medical facilities in the United States. By focusing specifically on hospitals equipped to provide surgical care, the study highlights a specialized and non-negotiable aspect of health services that is becoming harder to access for many. The findings were considered significant enough for presentation at a major medical conference, the American College of Surgeons Clinical Congress, underscoring their relevance to practicing surgeons and health care administrators.
The study serves as a clear warning about the growing divide in health care access between affluent and disadvantaged communities. While the economic pressures leading to hospital closures are complex, the outcome is straightforward: the communities with the fewest resources and the greatest health challenges are bearing the heaviest burden of a contracting health care system. The authors suggest that without targeted interventions, this trend will likely continue, further widening the gap in health outcomes across the nation.
