Although geographic access to emergency departments (EDs) has deteriorated in only a small number of communities, these communities tended to be poor, unemployed or Hispanic, suggesting an increasing disparity in access to emergency care.
From 1995 to 2001, the number of EDs in the U.S. decreased by almost 1,000, from 4,176 to 3,195. But ED visits increased by almost 19 million, from 96.5 million to 115.3 million, suggesting EDs are facing heavier patient demand. Using census, hospital survey and location data that encompassed 28,520 zip codes with a total population size of about 272 million people, this study examined one aspect of patient access—geographic access, as measured by driving time to EDs—to determine whether it had worsened from 2001 to 2005.
The authors note, geographic access is only one factor in patient access, and there are data limitations to this study regarding how drive time is calculated and how urban and rural areas are identified. However, this study raises concerns that those who depend on ED access the most are seeing the most declines. The authors call for more research on the impact of these declines on patients.