Study ID | Population | Comparison | Reported change in travel distance/time | Reported effect on mortality |
---|---|---|---|---|
Hsia 2012 [10] | General UEC | Increased distance vs. no change | Median 0.8 miles (range 0.1 to 33.4) | OR 1.04 (95% CI 0.99 to 1.09) |
Mustonen 2017 [12] | General UEC | ED closure vs. site with no closure | Not reported | No increase in any age group |
Knowles 2018 [3] | General UEC | ED closure vs. control site with no closure; before vs. after closure within sites; sub-areas at each site with above vs. below median change in travel time | Increased travel time range by site: 0–19, 0–22, 0–14, 0–23 and 0–25 min | No statistically reliable evidence to suggest a change in the number of deaths following an ED closure in any site or on average across all sites |
Avdic 2016 [6] | Acute MI | ED closure vs. sites with no closure | Median 13 km | Mean difference in survival to discharge 0.015 (72.4 vs. 74.9%) |
Shen 2012 [14] | Acute MI | Increased travel time vs. no change | No change 89.2%; < 10 min 8.9%; 10–30 min 1.7%; > 30 min 0.2% | Increase in mortality rate for those with > 30 min increase: 1.72 percentage points at 7 days, 1.23 at 30 days, 2.58 at 90 days, 4.49 at 180 days and 5.65 at 1 year |
Shen 2016 [15] | Acute MI | Increased travel time vs. no change | Categories as Shen 2012 | Increase in mortality rate for those with > 30 min increase: 6.58 percentage points (95% CI 2.49 to 10.68) at 90 days and 6.52 (95% CI 1.69 to 11.35) at 1 year. Significant but less pronounced effect for 10–30 min increase, no effect for < 10 min |
Hsia 2014 [11] | Trauma | Increased travel time vs. no increase (no change or decrease) | Average travel time to the nearest trauma centre was 47 min (interquartile range, 27–52) for patients who experienced an increase in travel time and 34 min (interquartile range, 23–35) for those who did not | OR for in-patient mortality 1.21 (95% CI 1.04 to 1.4) overall and 1.29 (95% CI 1.11 to 1.51) during the first 2 years after a closure |
Yaghoubian 2008 [16] | Trauma | Before vs. after trauma centre closure | Median transport time 12 (interquartile range 8–17) vs. 13 (9–17) minutes | Mortality rate increased from 5.4 to 7.3% but was lower in the later period after adjusting for severity score (OR 0.69, 95% CI 0.49 to 0.97) |
Combier 2013 [7] | Maternity | Before vs. after maternity unit closures | Mean time was estimated at 21 min in 2000 and at 24 min in 2009, while maximum time increased from 61 to 72 min | No significant association between travel time and stillbirth or perinatal mortality at any time point |