Does decreased access to emergency departments affect patient outcomes? Analysis of AMI population 1996-2005
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Authors
Shen, Yu-Chu
Hsia, Renee Y.
Subjects
emergency department access
patient outcome
patient outcome
Advisors
Date of Issue
2011-01
Date
Publisher
National Bureau of Economic Researcj
Language
Abstract
We analyze whether decreased emergency department access (measured by increased driving time to the nearest ED) results in adverse patient outcomes or changes in the patient health profile for patients suffering from acute myocardial infarction. Data soirces include 100% Medicare Provider Analysis and Review, AHA hospital annual surveys, Medicare hospital cost reports, and longitude and latitude information for 1995-2005. We define four ED access changes catagories and estimate a zip codes fixed-effects regression models on the following AMI outcomes: time-specific mortality rates, age, and probability of PTCA on the day of admission. We find a small increase in 30-day to 1-year mortality rates among patients in communities that experience <10-minute increase in driving time. Among patients in communities with >30-minute increases in driving times, we find a substantial increase in long-term mortality rates, a shift to younger ages (suggesting that the older ones die en route) and a higher probability of immediate PTCA. Most of the adverse effects disappear after the initial three-year transition window.
Type
Book
Description
Series/Report No
Department
Graduate School of Business & Public Policy (GSBPP)
Organization
Naval Postgraduate School (U.S.)
Identifiers
NPS Report Number
Sponsors
Funder
Format
Citation
NBER working Papers No. 16690
Distribution Statement
Rights
This publication is a work of the U.S. Government as defined in Title 17, United States Code, Section 101. Copyright protection is not available for this work in the United States.