How far to the hospital? The effect of hospital closures on access to care

Do urban hospital closures affect health care access or health outcomes? We study closures in Los Angeles County between 1997 and 2003, through their effect on distance to the nearest hospital. We find that increased distance to the closest hospital increases deaths from heart attacks and unintentional injuries. This finding is robust to several sensitivity checks. We also find that, for residents with health insurance, increased distance shifts regular care towards doctor's offices. While most residents are otherwise unaffected, we find some evidence that seniors perceive more difficulty accessing care. (c) 2005 Elsevier B.V. All rights reserved.