Readmissions following urban hospital closure

In 2022, Atlanta Medical Center (AMC), a major urban hospital in Atlanta, Georgia, closed. Anecdotal reports described increased emergency department use and difficulties with access to care as a result. Using Medicare fee-for-service data from 2022 to 2023, we identified patients who received a majority of their inpatient care at AMC in 2022 and measured the odds of a readmission, dying during a readmission, and readmission length of stay after AMC closed. We found that AMC patients had 27% lower odds of having a readmission compared to other hospital patients (adjusted odds ratio 0.73, 95% confidence interval 0.57, 0.93) after AMC closed. Nearly two-thirds of readmissions among AMC patients were to hospitals less than 5 miles from AMC. These findings may have been because of increased rates of leaving overcrowded emergency departments before being seen or higher admissions thresholds. These findings highlight the need to measure the closure of urban hospitals and their association with both clinical and healthcare use domains, as well as understanding the patterns of access available to patients when their "home" hospital closes.