Takeaway Message: In this study from England, the closure or downgrading of selected emergency departments had no observable impact on patient mortality.
Due to staffing shortages in the UK, the NHS has closed or reduced the capacity of some emergency departments thus strategically concentrating emergency services. The authors of this observational study sought to determine the impact on patient mortality from the closure of five emergency departments between 2007 and 2014. While transport time to an emergency department did increase by up to 25 minutes (median change - 9 minutes, range 0-25 minutes), no change in mortality was identified in the population studied.
The Bottom Line: Closure of selected emergency departments had no impact on population mortality in this UK study but the affected patients had other EDs in relatively close proximity to the ones that had closed.
Comment: This article's findings contradict those of a previously posted Pearl which noted a decrease in mortality when newly opened EDs reduced the volume of existing EDs (Woodworth L. Swamped: Emergency department crowding and patient mortality. Journal of Health Economics, 2020; 70: 102279). The reasons for this discrepancy are unclear but may be due to differences in the healthcare systems of the US and UK.
References
Knowles E, Shephard N, Stone T_, et al_
The impact of closing emergency departments on mortality in emergencies: an observational study
