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To determine factors associated with emergency department (ED) closure, these researchers analyzed data from the American Hospital Association and Medicare from 1990 through 2009. The analysis was restricted to nonrural hospitals.
During the study period, the number of hospital EDs decreased from 2446 to 1779 (27% drop); 66% of ED losses resulted from closure of hospitals that operated EDs, and 34% resulted from ED closure only. In multivariate analysis, factors that were significantly associated with ED closure included low profit margin (hazard ratio, 1.9), for-profit hospital ownership (HR, 1.8), presence of another ED within 15 miles (HR, 1.8), safety-net status (hospital provides more than twice the Medicaid share of discharges as hospi…