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How Far to the Hospital? The Effect of Hospital Closures on Access to Care

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Author Info
Thomas C. Buchmueller
Mireille Jacobson
Cheryl Wold

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Abstract

Do urban hospital closures affect health care access or health outcomes? We study closures in Los Angeles County between 1997 and 2003, through their effect on distance to the nearest hospital. We find that increased distance to the nearest hospital shifts regular care away from emergency rooms and outpatient clinics to doctor's offices. While most residents are otherwise unaffected by closures, lower-income residents report more difficulty accessing care, working age residents are less likely to receive HIV tests, and seniors less likely to receive flu shots. We also find some evidence that increased distance raises infant mortality rates and stronger evidence that it increases deaths from unintentional injuries and heart attacks.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 10700.

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Date of creation: Aug 2004
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Handle: RePEc:nbr:nberwo:10700

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Find related papers by JEL classification:
I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
I12 - Health, Education, and Welfare - - Health - - - Health Production

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  1. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-in-Differences Estimates?," The Quarterly Journal of Economics, MIT Press, vol. 119(1), pages 249-275, February. [Downloadable!] (restricted)
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  2. Jerry A. Hausman & Bronwyn H. Hall & Zvi Griliches, 1984. "Econometric Models for Count Data with an Application to the Patents-R&D Relationship," NBER Technical Working Papers 0017, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  3. Lindrooth, Richard C. & Lo Sasso, Anthony T. & Bazzoli, Gloria J., 2003. "The effect of urban hospital closure on markets," Journal of Health Economics, Elsevier, vol. 22(5), pages 691-712, September. [Downloadable!] (restricted)
  4. Moulton, Brent R., 1986. "Random group effects and the precision of regression estimates," Journal of Econometrics, Elsevier, vol. 32(3), pages 385-397, August. [Downloadable!] (restricted)
  5. Ai, Chunrong & Norton, Edward C., 2003. "Interaction terms in logit and probit models," Economics Letters, Elsevier, vol. 80(1), pages 123-129, July. [Downloadable!] (restricted)
  6. Janet Currie & Patricia B. Reagan, 2003. "Distance to Hospital and Children's Use of Preventive Care: Is Being Closer Better, and for Whom?," Economic Inquiry, Oxford University Press, vol. 41(3), pages 378-391, July. [Downloadable!] (restricted)
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