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Table 1 Characteristics of included studies

From: Effects of service changes affecting distance/time to access urgent and emergency care facilities on patient outcomes: a systematic review

Study ID

Country

Study design

Condition

Intervention

Sample source

Sample size

Length of study

Avdic 2016 [6]

Other Europe

Sweden

Controlled observational

Analysis of linked administrative datasets

Acute MI

Hospital ED closure

Administrative registers obtained from the Swedish National Board of Health and Welfare (hospitalisations and deaths)

Approximately 374,000 events

21 years (1990–2010)

Combier 2013 [7]

France

Burgundy region

Uncontrolled observational

Before–after study

Obstetric/neonatal complications

Obstetric unit closure

Hospital discharge summary data for all deliveries from 22 weeks’ gestation in the region’s maternity units

111,001 deliveries

10 years (2000–2009)

El Sayed 2012 [8]

USA

Uncontrolled observational

Before–after study

General emergency care

Hospital ED merger

Routinely collected EMS and ED data

5338 EMS transports; 21,685 ED visits

3 months (June 1 to August 262,010)

Hansen 2011 [9]

Other Europe

Denmark

Uncontrolled observational

Before–after study

General emergency care

Hospital ED closure

Danish National Person Registry including all Danish residents

21,000 residents of Viborg county (2300 from Morso)

7 years (1997–2003)

Hsia 2012 [10]

USA

California

Controlled observational

Cohort

General emergency care

Acute MI, stroke, sepsis and asthma/COPD

Hospital ED closure

California Office of State-wide Health and Planning Development database, combined with information on ED closures by year between 1999 and 2009

785,385, of whom 67,577 (8.6%) experienced an increase in distance to ED care as a result of an ED closure

11 years (1999 to 2009)

Hsia 2014 [11]

USA

Other cross-sectional comparison of existing datasets, compared at T1 and T2 10 years later.

Major trauma

Acute trauma aged 20 or older.

Trauma unit closure

Database of trauma centres open at T1 and 10 years later at T2. Patient discharge database. Household demographic database.

266,023 had no increased drive time, 5122 had increased drive time.

Compared 1999 to 2009

Knowles 2018 [3]

UK

Controlled observational

Interrupted time series

General emergency care

Hospital ED closure or downgrade

ONS, HES, ambulance dispatch records

Unable to locate, refers to areas only

Two years pre closure and 2 years post closure.

Mustonen 2017 [12]

Other Europe

Finland (Vantaa, Finland’s third-largest city, with approximately 182,000 inhabitants)

Controlled observational

Controlled before–after study

General emergency care

Primary care ED closure

Electronic health records plus monthly mortality statistics by age groups

Unclear (34,000 inhabitants in area with ED closure)

4 years (February 2004 to December 2007)

Roberts 2014 [13]

UK

England only

Uncontrolled observational

National data on distance travelled to emergency care plus three case studies of local reconfiguration

General emergency care

Hospital ED closure or relocation

Hospital Episode Statistics plus data on ED attendances from every major (type 1) ED in England

13 million ED attendances and 5.4 million emergency admissions (2011/12)

10 years (2001/2 to 2011/12)

Shen 2012 [14]

USA

Controlled observational

Difference in difference approach

Acute MI

Hospital ED closure or relocation

American hospital annual survey, database for California hospitals, Medicare claims

Unclear

4 years before change to 4 years after change to ED access

Shen 2016 [15]

USA

Controlled observational

Acute MI

Hospital ED closure or relocation

Medicare records, cost provider systems

1.35 million patients

90-day mortality reported in this paper

Yaghoubian 2008 [16]

USA

California (Los Angeles County)

Uncontrolled observational

Interrupted time series

Major trauma

Trauma centre closure

Patient records from prospectively collected database (Trauma and Emergency Medicine Information System)

14,996

9 years 2 months (January 1997 to 1 March 2006)