Analyzing the urban–rural divide: the role of location, time, and breach characteristics in U.S. hospital security incidents, 2012–2021

Abstract

This analysis describes how cybersecurity breaches vary between urban and rural hospitals, how they differ over time, and how they differ across different types and locations of breaches within hospitals. Utilizing data from the U.S. Department of Health and Human Services Office for Civil Rights on incidents from 2012 to 2021 that affected 500 or more individuals, we studied breaches in 237 community hospitals, distinguishing between 185 urban and 52 rural facilities. Using Poisson and Quasi-Poisson regression models, we found a significant yearly increase in data breaches, especially in urban hospitals. Hacking/IT incidents were the most common breaches, particularly prevalent in urban settings, while unauthorized access/disclosure occurred frequently. Email and network servers were the primary locations of breaches in urban and rural hospitals. These findings indicate differences between urban and rural hospitals in data security incidents, suggesting areas for further research.