When a hospital closes in a community, patients may travel further to an emergency department (ED) to receive care likely resulting in longer travel times. In this paper we empirically estimate how hospital closures affect the time needed to transport a patient to an ED in an ambulance in the period immediately after the hospital closes. We find that urban patients have a fairly small change in transportation time in zip codes where a hospital closes, but that rural patients average an estimated 15.7 additional minutes in the total response time it takes to transport them to a hospital in the year after a hospital closes in their zip code--a 46 percent increase compared to the year before the closure. This increase in time to the ED is primarily the result of an almost 14 minute or 100 percent increase in the time it takes to transport a patient from the location of the incident to the hospital. We find that the impact on Medicare eligible patients living in rural areas is even larger. We find no change in the time it takes ambulances to arrive at an incident and only a small change in the time spent at the scene. Our work measures one aspect of how access to emergency care through ambulance services changes for patients when a hospital closes, specifically how it affects their time in an ambulance to receive emergency care. |
