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<p>In this study, we examine how rural versus urban geographic delineation can lead to spillover in the context of COVID-19 hospitalizations using panel data collected from a number of sources over a period of 22&#xa0;months for all 115 counties within the state of Missouri in the United States (U.S.). Results of our spatial interaction analyses show that there is significant evidence of spillover effect in COVID-19 hospitalizations, whereby COVID-19 hospitalizations in one county influence COVID-19 hospitalizations in its neighboring counties in Missouri. This effect can be effectively predicted by rural versus urban geographical delineation, and the effect does not remain static over time. Our study has numerous implications for counties, state governments, and healthcare institutions planning to manage their reactivity to the next pandemic or to simply better understand the way demand for healthcare crosses regional boundaries.</p>

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Rural spillover and urban hospital overwhelm: lessons from COVID-19

  • 期刊论文

  • 发表日期：

    2025年11月1日

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  • Raju Mainali,
  • Jo Lynne Stalnaker,
  • Ravi Thambusamy,
  • E. Mitchell Church

摘要

In this study, we examine how rural versus urban geographic delineation can lead to spillover in the context of COVID-19 hospitalizations using panel data collected from a number of sources over a period of 22 months for all 115 counties within the state of Missouri in the United States (U.S.). Results of our spatial interaction analyses show that there is significant evidence of spillover effect in COVID-19 hospitalizations, whereby COVID-19 hospitalizations in one county influence COVID-19 hospitalizations in its neighboring counties in Missouri. This effect can be effectively predicted by rural versus urban geographical delineation, and the effect does not remain static over time. Our study has numerous implications for counties, state governments, and healthcare institutions planning to manage their reactivity to the next pandemic or to simply better understand the way demand for healthcare crosses regional boundaries.