ArticleAnnals of emergency medicine2012
System-level health disparities in California emergency departments: minorities and Medicaid patients are at higher risk of losing their emergency departments.
Article in Annals of emergency medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Community Characteristics Associated With Health System Penetration.Medical care research and review : MCRR · 2026Article
- Trends and Hospital Factors in Emergency Department Patients Leaving Without Being Seen, 2015-2024.JAMA network open · 2026Article
- Impact of Residential Segregation on Healthcare Utilization and Perceived Quality of Care Among Informal Caregivers in the United States.Journal of racial and ethnic health disparities · 2025Article
- Racial and ethnic disparities in emergency department transfers to public hospitals.Health services research · 2024Article
- Patterns in Patient Encounters and Emergency Department Capacity in California, 2011-2021.JAMA network open · 2023Article
- A Conceptual Framework for Optimizing the Equity of Hospital-Based Emergency Care: The Structure of Hospital Transfer Networks.The Milbank quarterly · 2023Article
- Disparities in Spatial Access to Emergency Surgical Services in the US.JAMA health forum · 2022Article
- Effect of an Emergency Department Closure on Homeless Patients and Adjacent Hospitals.The western journal of emergency medicine · 2022Article
- Structural Discrimination in Emergency Care: How a Sick System Affects Us All.Med (New York, N.Y.) · 2022Article
- Association of Emergency Department Payer Mix with ED Receipt of Telehealth Services: An Observational Analysis.The western journal of emergency medicine · 2022Observational
- Emergency Department Closures And Openings: Spillover Effects On Patient Outcomes In Bystander Hospitals.Health affairs (Project Hope) · 2019Article
- Variation in outcomes among 24/7 percutaneous coronary intervention centres for patients resuscitated from out-of-hospital cardiac arrest.Resuscitation · 2019Article
- Article
- Geographic Diffusion and Implementation of Acute Care Surgery: An Uneven Solution to the National Emergency General Surgery Crisis.JAMA surgery · 2018Article
- Decline In Public Substance Use Disorder Treatment Centers Most Serious In Counties With High Shares Of Black Residents.Health affairs (Project Hope) · 2016Article
- The Impact of Hospital Closures and Hospital and Population Characteristics on Increasing Emergency Department Volume: A Geographic Analysis.Population health management · 2015Article
- Invasive Mechanical Ventilation in California Over 2000-2009: Implications for Emergency Medicine.The western journal of emergency medicine · 2015Article
- Travel distances, socioeconomic characteristics, and health disparities in nonurgent and frequent use of Hospital Emergency Departments in South Carolina: a population-based observational study.BMC health services research · 2015Observational
- California emergency department closures are associated with increased inpatient mortality at nearby hospitals.Health affairs (Project Hope) · 2014Article
- Factors associated with short-term bounce-back admissions after emergency department discharge.Annals of emergency medicine · 2013Article
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Authors and funding
5 authors.
Funding
Abstract
STUDY
objectiveEmergency department (ED) closures threaten community access to emergency services, but few data exist to describe factors associated with closure. We evaluate factors associated with ED closure in California and seek to determine whether hospitals serving more vulnerable populations have a higher rate of ED closure.
methodsThis was a retrospective cohort study of California hospital EDs between 1998 and 2008, using hospital- and patient-level data from the California Office of Statewide Health Planning and Development (OSHPD), as well as OSHPD patient discharge data. We examined the effects of hospital and patient factors on the hospital's likelihood of ED closure by using Cox proportional hazards models.
resultsIn 4,411 hospital-years of observation, 29 of 401 (7.2%) EDs closed. In a model adjusted for total ED visits, hospital discharges, trauma center and teaching status, ownership, operating margin, and urbanicity, hospitals with more black patients (hazard ratio [HR] 1.41 per increase in proportion of blacks by 0.1; 95% confidence interval [CI] 1.16 to 1.72) and Medi-Cal recipients (HR 1.17 per increase in proportion insured by Medi-Cal by 0.1; 95% CI 1.02 to 1.34) had higher risk of ED closure, as did for-profit institutions (HR 1.65; 95% CI 1.13 to 2.41).
conclusionThe population served by EDs and hospitals' profit model are associated with ED closure. Whether our findings are a manifestation of poorer reimbursement in at-risk EDs is unclear.
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