Does Decreased Access to Emergency Departments Affect Patient Outcomes?

Analysis of Acute Myocardial Infarction Population 1996-2005

By measuring increased driving time to the nearest emergency department (ED), this study examines ED access and adverse patient outcomes or changes in patient health profiles. Using acute myocardial infarction (AMI) patients, the study looks at whether increased driving time to the nearest ED results in higher mortality rates among AMI patients and results in health profile changes in AMI patients arriving alive in the hospital.

Using data from the American Hospital Association annual survey and each patient’s ZIP code, driving time between each patient to the nearest ED was calculated. The study included 150,000 patients per year from 1996 to 2005.

Key Findings:

  • The majority of the study population (89.2%) did not experience increased driving times to the nearest ED over the course of the study.
  • Small increases in driving time (less than 10 minutes) had a small adverse effect on 30-day to 1-year mortality rates.
  • Increase in driving time of more than 30 minutes increased the observed long-term mortality rates, and changed the health profile of the admitted patients (younger age, and higher probability of receiving percutaneous transluminal coronary angioplasty (PTCA) on the day of admission.

This article discusses important issues regarding resource allocation of the emergency care system, however, further attention is needed to best allocate health care resources among emergency care.

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