Emergency RoomA new study of California Hospitals found that patients admitted into the emergency rooms of a hospital are at greater risk of dying if another emergency room at a hospital nearby has closed its doors. The research was primarily conducted to identify the potential impact of emergency room closures on patient care quality at the hospitals functioning within the same service area.

The study published in the August issue of the medical journal Health Affairs aimed to find out how the disappearance of emergency rooms translated into high mortality rate for hospital patients. Less number of ERs means longer wait times to receive treatment. It also necessitates patients to travel farther to get ER care and this may force them to stay at home. This may in turn force them to stay longer and by the time they are admitted to a hospital, they would have become seriously sick.

Understanding the Implications of ER Closures

Recognizing the possible implications of ER closures is very crucial as they have been disappearing for years. Researchers examined the effects of these ED closures in California between the year 1999- 2010 and found that patients who were treated at nearby hospitals following the closings were 5% more likely to die. The total number of EDs in the US reduced from 4,884 in 1996 to 4,594 in 2009, thereby recording a 6% decline. Whereas patient visits increased from 90 million to 136 million, nearly 51% increase.

As part of the study, researchers analyzed data from the California Office of Statewide Health Planning and Development to determine how many ERs were functioning and the status of those patients who were treated. The key findings of the study are mentioned below –

  • About 26 hospitals suffered ED shutdowns and 22 others closed these departments but remained open (from the year 1999-2010). Each of these 48 hospitals affected a geographic area that was identified by the patient ZIP codes who used the facilities.
  • It was found that more than 16 million patients who visited California ERs were admitted to the hospital. From that, 25% of them were from nearby hospitals affected by the closure, and 75% were not.
  • Patients or non-elderly adults (including African Americans, women or adults) in the age group of 18-65 years have 10% increased risk of suffering death in hospitals than other younger patients not affected by closures. This was the case among uninsured patients or those not covered by Medicaid, the federal health insurance programs for low-income Americans.
  • Elderly patients (65 years or more) had more chances of suffering death after being admitted to hospitals from an affected area.

Researchers also conducted a separate analysis of the percentage of patients who went to an ED on account of certain chronic and time-sensitive medical emergency. It was found that patients suffering from certain specific ailments were likely to die in hospitals due to lost ERs.

  • Heart attack patients were 15% more likely to die in a hospital
  • Patients who suffered stroke were 10% more likely to die in a hospital
  • Patients with a life-threatening infection causing sepsis were 8% more likely to die

Experts in the healthcare domain say that the closure of ER rooms puts considerable strain on the healthcare system which in turn leads to overcrowding and high death rates of patients admitted through these rooms. Moreover, such ED closures may increase inpatient mortality in hospitals and communities with more minority, Medicaid and low-income patients.