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

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.