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Centralization of emergency hospital care is not associated with increased in-hospital mortality; a population-based
Søren Bie Bogh1, Jonathan Harbak2, Marianne Fløjstrup3
1Associated professor, OPEN, Odense Patient Data Explorative Network, University of Southern Denmark and Odense University Hospital, DK-5000 Odense C, Denmark.
Background:
We describe changes in the distance travelled, the utilization of emergency services, and the inhospital mortality before and after the centralization of hospital emergency services in Denmark.
Methods:
All unplanned non-psychiatric hospital contacts from adults (aged ≥18 years) in 2008 and 2016 are included. Analyses are age-standardized and conducted at a municipality level. The municipalities are divided into groups according to the presence of emergency hospital services.
Results:
Municipalities where hospitals with emergency services have been closed differed by having the most significant increase in distance travelled from 2008 to 2016. All groups experienced a reduction in overall in-hospital mortality. The reduction in mortality was not present for acute myocardial infarct contacts from municipalities where hospitals with emergency services have been closed.
Conclusion:
Our data do not suggest that hospital closures, and thereby increased travel distance, have contributed significantly as a barrier to emergency-care access and changes to in-hospital mortality.
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