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

  • Thomas C. Buchmueller
  • Mireille Jacobson
  • Cheryl Wold

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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File URL: http://www.nber.org/papers/w10700.pdf
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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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Publication status: published as Buchmueller, Thomas C. & Jacobson, Mireille & Wold, Cheryl, 2006. "How far to the hospital?: The effect of hospital closures on access to care," Journal of Health Economics, Elsevier, vol. 25(4), pages 740-761, July.
Handle: RePEc:nbr:nberwo:10700
Note: HE
Contact details of provider: Postal: National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.
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  1. Hausman, Jerry & Hall, Bronwyn H & Griliches, Zvi, 1984. "Econometric Models for Count Data with an Application to the Patents-R&D Relationship," Econometrica, Econometric Society, vol. 52(4), pages 909-38, July.
  2. Thomas C. Buchmueller & Mireille Jacobson & Cheryl Wold, 2004. "How Far to the Hospital? The Effect of Hospital Closures on Access to Care," NBER Working Papers 10700, National Bureau of Economic Research, Inc.
  3. Gabor Kezdi, 2005. "Robus Standard Error Estimation in Fixed-Effects Panel Models," Econometrics 0508018, EconWPA.
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  6. Ruhm, Christopher J., 2003. "Healthy Living in Hard Times," IZA Discussion Papers 711, Institute for the Study of Labor (IZA).
  7. Christopher J. Ruhm, 2000. "Are Recessions Good For Your Health?," The Quarterly Journal of Economics, MIT Press, vol. 115(2), pages 617-650, May.
  8. Moulton, Brent R., 1986. "Random group effects and the precision of regression estimates," Journal of Econometrics, Elsevier, vol. 32(3), pages 385-397, August.
  9. Ai, Chunrong & Norton, Edward C., 2003. "Interaction terms in logit and probit models," Economics Letters, Elsevier, vol. 80(1), pages 123-129, July.
  10. 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, Western Economic Association International, vol. 41(3), pages 378-391, July.
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