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The Mortality Effects of Healthcare Consolidation: Evidence from Emergency Department Closures

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  • Pinka Chatterji
  • Chun-Yu Ho
  • Xue Wu

Abstract

We examine whether loss of emergency department services is associated with county-level mortality rates in rural areas over the period 2005-2018. We use a propensity-weighted difference-in-difference approach, comparing counties that lost emergency department services to counties that retained them during our period. In the full sample, we find no effects of emergency department closure on all-cause mortality; drug, alcohol, and suicide deaths; or AMI mortality. We find that closure is associated with increased drug-related deaths among white and younger-aged females, and in the Midwest and the West, as well as an increase in AMI mortality in the South and West.

Suggested Citation

  • Pinka Chatterji & Chun-Yu Ho & Xue Wu, 2024. "The Mortality Effects of Healthcare Consolidation: Evidence from Emergency Department Closures," NBER Working Papers 32189, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:32189
    Note: EH
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    References listed on IDEAS

    as
    1. Woodworth, Lindsey, 2020. "Swamped: Emergency Department Crowding and Patient Mortality," Journal of Health Economics, Elsevier, vol. 70(C).
    2. Anne Case & Angus Deaton, 2017. "Mortality and Morbidity in the 21st Century," Working Papers 2017-spring, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
    3. Kritee Gujral & Anirban Basu, 2019. "Impact of Rural and Urban Hospital Closures on Inpatient Mortality," NBER Working Papers 26182, National Bureau of Economic Research, Inc.
    4. Alexander, Diane & Richards, Michael R., 2023. "Economic consequences of hospital closures," Journal of Public Economics, Elsevier, vol. 221(C).
    5. Anne Case & Angus Deaton, 2017. "Mortality and Morbidity in the 21st Century," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 48(1 (Spring), pages 397-476.
    6. Goodman-Bacon, Andrew, 2021. "Difference-in-differences with variation in treatment timing," Journal of Econometrics, Elsevier, vol. 225(2), pages 254-277.
    7. Sun, Liyang & Abraham, Sarah, 2021. "Estimating dynamic treatment effects in event studies with heterogeneous treatment effects," Journal of Econometrics, Elsevier, vol. 225(2), pages 175-199.
    8. Bresnahan, Timothy F & Reiss, Peter C, 1991. "Entry and Competition in Concentrated Markets," Journal of Political Economy, University of Chicago Press, vol. 99(5), pages 977-1009, October.
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    More about this item

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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