[Closure of emergency hospitals - a reemerging issue in Sweden]

As the finances of health care providers are increasingly strained, discussions about the closure of some of the emergency hospitals in Sweden have reemerged. I have reviewed the 39 closures that have occurred over the last half century. The closures have come in two distinct waves. The first wave, peaking in 1970-74, was driven by staffing problems with concerns about the quality of care. The second, more prolonged wave occurred in 1995-2004, caused by healthcare providers' strained economy. In 2024, the first closure of an emergency hospital since 2010 occurred and the future of several emergency hospitals is being investigated. A low population in the hospital catchment area has been a strong predictor of hospital closure, but the closure has seldom been followed by a marked population drop. Major arguments in the current debate on emergency hospital closures are listed. The process from a first external evaluation to final closure has followed a stereotypic, often dramatic pattern.