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Member Research & Reports

Member Research & Reports

UNC: Hospital Closures in Rural Communities Lead to Longer Ambulance Drives

Emergency medical services (EMS) can often be the difference between life and death in critical health care outcomes, especially in acute cases like heart attack or stroke. People in rural areas of the United States wait, on average, nearly twice as long for ambulances as those in urban areas. New research from the University of North Carolina Gillings School of Global Public Health has found that hospital closures in rural areas increase those EMS transport times.

Many rural hospitals struggle to remain financially viable, and hospital closures are becoming more and more common in these areas. This puts a population that already experiences longer wait times for acute medical care even more at risk for poor health outcomes, not only because the distance between the patient and the nearest hospital increases, but also because hospital closures often mean the hospital-based EMS agency may also close. This requires the 9-1-1 dispatcher to notify an EMS agency that may be farther away from the patient.

Ms. Katherine Miller, doctoral student and graduate teaching assistant in health policy and management at the Gillings School, is first author on a study that sought to quantify the effect of these closures on EMS response and transport times. The study, published recently in Health Services Research, also includes work from Ms. Hailey James, a doctoral student, and Dr. Mark Holmes, a faculty member, both of the health policy and management department.

The study found that in the year a hospital closed in a rural area, average EMS transport and activation times increased. The closure did not affect average EMS response times. EMS transport times increased by an average of 2.6 minutes, and EMS activation times increased by an average of 7.2 minutes.

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