How Far to the Hospital? The Effect of Hospital Closures on Access to Care

Thomas C. Buchmueller, Mireille Jacobson, Cheryl Wold

NBER Working Paper No. 10700
Issued in August 2004
NBER Program(s):Health Economics

Do urban hospital closures affect health care access or health outcomes? We study closures in Los Angeles County between 1997 and 2003, through their effect on distance to the nearest hospital. We find that increased distance to the nearest hospital shifts regular care away from emergency rooms and outpatient clinics to doctor's offices. While most residents are otherwise unaffected by closures, lower-income residents report more difficulty accessing care, working age residents are less likely to receive HIV tests, and seniors less likely to receive flu shots. We also find some evidence that increased distance raises infant mortality rates and stronger evidence that it increases deaths from unintentional injuries and heart attacks.

download in pdf format
   (327 K)

email paper

The NBER Bulletin on Aging and Health provides summaries of publications like this.  You can sign up to receive the NBER Bulletin on Aging and Health by email.

Machine-readable bibliographic record - MARC, RIS, BibTeX

Document Object Identifier (DOI): 10.3386/w10700

Published: Buchmueller, Thomas C. & Jacobson, Mireille & Wold, Cheryl, 2006. "How far to the hospital?: The effect of hospital closures on access to care," Journal of Health Economics, Elsevier, vol. 25(4), pages 740-761, July. citation courtesy of

Users who downloaded this paper also downloaded* these:
Currie and Reagan w6836 Distance to Hospitals and Children's Access to Care: Is Being Closer Better, and for Whom?
Escarce, Gresenz, and Rogowski w10799 Healthcare Markets, the Safety Net and Access to Care Among the Uninsured
Town, Wholey, Feldman, and Burns w11087 Did the HMO Revolution Cause Hospital Consolidation?
Goldman and Romley w14619 Hospitals As Hotels: The Role of Patient Amenities in Hospital Demand
Barro and Cutler Consolidation in the Medical Care Marketplace,A Case Study from Massachusetts
NBER Videos

National Bureau of Economic Research, 1050 Massachusetts Ave., Cambridge, MA 02138; 617-868-3900; email:

Contact Us