Effect of Decreased Emergency Department Access on Patient Outcomes

The researchers will examine whether decreased emergency department (ED) access results in adverse patient outcomes or changes in other health indicators. There is a great deal of literature documenting decreased access to EDs. However, there is little empirical evidence linking access to EDs and health outcomes. The researchers will use acute myocardial infarction (AMI) patients to examine health outcomes, since AMI patients are relatively homogeneous and the time sensitivity of treatment should be reflected in differences in outcomes. They will examine two types of ED access between 1995 and 2005: permanent ED closure and temporary ED closure as measured by ambulance diversion time. Specifically, the researchers will focus on how changes in distance to the closed ED affect health outcomes of two types of AMI patients: 1) those who survived the ambulance ride and have an outpatient claim from the ED; and 2) those who survived the ED admission to have an inpatient claim. The objective of this project is to provide improved understanding of the impact of ambulance diversion in the health care system.