U.S. hospitals have closed one out of four emergency departments over the last two decades, even though emergency visits were rising, according to a study published in the Journal of the American Medical Association.
The number of EDs in urban areas dropped 27 percent to 1,779 in 2009 from 2,446 in 1990, while the number of emergency visits jumped to 127 million in 2009 from 89 million in 1991. The closures exacerbate the ever present problem of ED overcrowding, hence jeopardizing emergency care, notes the study's lead author Renee Hsia.
Hospitals with for-profit ownership, that are located in highly competitive markets, that boast safety-net status, or have low profit margin all are at a higher risk of closing their EDs, according to the study.
Researchers used AHA data on ED closures from 1990 to 2009, and merged it with hospital financial and payer information from Medicare cost reports.