Closure rates were almost the same between urban and rural hospitals. The United States is losing hospitals faster than it can open new ones, a worsening trend in both rural and urban areas, according to a new study by the Harvard T.H.

Chan School of Public Health. More than 400 hospitals closed across the country from 2010 to 2025, according to the study, which analyzed data from the American Hospital Association’s annual survey. Year over year, the rate of hospital closures has increased by 4 percent, and the rate of openings has decreased by 3 percent.

Between hospital openings and closures, there was a net loss of 216 hospitals and more than 24,000 beds. The hospitals that closed were more likely to be smaller, for-profit and safety-net hospitals, which generally treat more vulnerable communities and uninsured patients, the study said.

“Many policymakers have been treating hospital closures as a rural problem, but our data show it’s a national problem,” Thomas Tsai, an associate professor of health policy and management and an author of the study, said in a news release.

While the Trump administration has announced efforts to bolster rural health care, the study said that similar attention has not been directed to urban hospitals.

Hospitals could face further strain due to Medicaid coverage losses and payment cuts from President Donald Trump’s One Big Beautiful Bill, the study said.

“We must shift away from only asking ourselves how we can save rural hospitals, and start asking: How do we protect access to hospital care for vulnerable communities, wherever they are?”Tsai said.