Urban hospital closures might improve the efficiency of the health care system by shifting patient care to doctors' offices, but such closures also result in some groups perceiving limited access to health care, according to a study published in the Journal of Health Economics.
For the study, researchers examined hospital closures that occurred in Los Angeles County between 1997 and 2003. About 10% of hospitals in the county closed between 1997 and 2002, and nine more acute care hospitals have closed in the county since 2002.
Researchers found that as distance to the closest hospital increases, more deaths from heart attacks and unintentional injuries occurred. However, among patients who have health insurance, greater distance to the nearest hospital resulted in more people seeking care at doctors' offices, according to the study.
The authors recommended that low-cost, nonhospital-based preventive care be promoted as a method of reducing patient deaths after a hospital closure (Buchmueller et al., Journal of Health Economics, July 2006).
The August issue of the Annals of Emergency Medicine includes three Institute of Medicine reports addressing the future of emergency and trauma care in the U.S. The reports examine hospital-based emergency and trauma care, emergency medical services and emergency care for children.
The IOM makes a number of recommendations to improve the emergency care system, including that steps be taken to:
- Improve hospital efficiency and patient flow using information technology and other tools;
- Develop a coordinated, regionalized emergency system, beginning by providing funding for a five-year demonstration program of such systems in different areas of the country;
- Increase funding for EMS research, hospital reimbursements and disaster preparedness; and
- Consider pediatric needs in emergency care planning (Annals of Emergency Medicine, August 2006).