NATIONAL BUREAU OF ECONOMIC RESEARCH
NATIONAL BUREAU OF ECONOMIC RESEARCH

Does Decreased Access to Emergency Departments Affect Patient Outcomes? Analysis of AMI Population 1996-2005

Yu-Chu Shen, Renee Y. Hsia

NBER Working Paper No. 16690
Issued in January 2011
NBER Program(s):   HC

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 sources 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 change categories 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 time, 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.

download in pdf format
   (1195 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.

This paper is available as PDF (1195 K) or via email.

Machine-readable bibliographic record - MARC, RIS, BibTeX

Document Object Identifier (DOI): 10.3386/w16690

Published: Shen, Y. and Hsia, RY. 2012. Does Decreased Access to Emergency Departments Affect Patient Outcomes? Analysis of AMI Population 1996-2005. Health Services Research, 47(1, Part 1): 188-210.

Users who downloaded this paper also downloaded these:
Goodwin, Mishra, and Ortalo-Magné w16693 The Buck Stops Where? The Distribution of Agricultural Subsidies
Babcock, Bedard, Charness, Hartman, and Royer w16687 Letting Down the Team? Evidence of Social Effects of Team Incentives
Hong and Yogo w16712 What Does Futures Market Interest Tell Us about the Macroeconomy and Asset Prices?
Azoulay, Graff Zivin, and Sampat w16683 The Diffusion of Scientific Knowledge Across Time and Space: Evidence from Professional Transitions for the Superstars of Medicine
Li and Whalley w16686 Rebalancing and the Chinese VAT: Some Numerical Simulation Results
 
Publications
Activities
Meetings
NBER Videos
Data
People
About

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

Contact Us