Researchers from UC San Francisco have found a link between emergency department closures and increased inpatient mortality rates at hospitals in the surrounding area.
Researchers examined more than 16 million emergency admissions to California hospitals between 1999 and 2010. In this timeframe, 48 EDs were closed throughout the state. Here are some of their findings.
- Patients admitted to facilities in the vicinity of a recently closed ED saw a 5 percent higher chance of death than patients admitted to hospitals that were not close to a recently closed ED.
- The mortality rate increase was higher for certain time-sensitive conditions, including heart attack (15 percent higher odds of dying), stroke (10 percent) and sepsis (8 percent).
- Researchers said the findings are concerning at a national level, as the annual number of ED visits increased by 51 percent from 1996 to 2009, but the number of available EDs decreased by 6 percent in that timeframe.
Renee Hsia, MD, associate professor at UCSF and senior study author, said the findings suggest ED closures affect many more patients than previously thought.
"Our findings indicate that disproportionate numbers of ED closures may be driving up inpatient mortality in communities and hospitals with more minority, Medicaid and low-income patients, and contributing to existing disparities in health outcomes," Dr. Hsia said. "These results suggest that health systems and policy makers should consider the ripple effect on communities when they regulate ED closures."
The study is also published in Health Affairs.
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