Research in Progress Seminar (HRP 283)

Date: May 25, 2016  
Time: 4:00 - 5:00 pm  
Location: CHP/PCOR Conference Room
117 Encina Commons

Yu-Chu Shen, PhD
Professor of Economics, Graduate School of Business and Public Policy, Naval Postgraduate School
Faculty Research Fellow, National Bureau of Economic Research
Adjunct Affiliate, PCOR, Stanford

Title: The Effect of Emergency Department Closure on Treatment, Access, and Health Outcomes Among Patients with Acute Myocardial Infarction


Emergency Departments (ED) are critical to the U.S. health care system, and ED closures can have a profound effect on a community. On one hand, prior literature has documented some adverse effects of ED closures. On the other hand, it has been posited that closures of EDs could improve acute care by removing poor-performers from the market. Moreover, permanent closure of a local ED could have an amplified effect for patients experiencing time-sensitive illnesses requiring prompt intervention, such as acute myocardial infarction (AMI). In this study using nationally representative data, we explore the mechanisms through which permanent ED closure affects patient access, treatment, and health outcomes in a community. Specifically, we compare changes in access to cardiac technology (availability of cath lab, cardiac care unit, and cardiac surgery capacity), treatment received (PTCA and thrombolytic therapy), and health outcomes (30-day, 90-day, and 1-year mortality, and 30-day all cause readmission) among Medicare AMI patients whose communities experience varying degrees of increase in driving time to their next available ED when the closest ED to the community shuts down, relative to patients from communities that do not experience any permanent ED closure.

In collaboration with Renee Hsia, UCSF.