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September 7, 2011

Emergency Department Closures in the United States—Reply

Author Affiliations

Author Affiliations: Department of Emergency Medicine, University of California, San Francisco (Dr Hsia) (renee.hsia@ucsf.edu); Health Research Division, RAND Health, Washington, DC (Dr Kellermann); and National Bureau of Economic Research, Cambridge, Massachusetts (Dr Shen).

JAMA. 2011;306(9):929-930. doi:10.1001/jama.2011.1258

In Reply: We noted in our article that 66% of ED closures were a consequence of hospital closures and the remaining 34% were ED-only closures (where the hospital remained open but discontinued provision of emergency services). Drs Wan and Wang are correct in commenting that we did not control for hospital closure in the analysis. The intent of the study was to examine closure of EDs, whether or not it was accompanied by closure of the entire hospital. From the perspective of a patient in need of emergency care, the lack of a nearby ED is what matters.