Journey Distances To Hospital Can Be Fatal

August 2007 - Research led by Jon Nicholl, director of the Medical Care Research Unit at the University of Sheffield, funded by the Department of Health and published in Emergency Medicine Journal has found that the further patients with life-threatening conditions have to travel by ambulance to reach emergency care, the more likely they are to die, with people suffering respiratory problems at greatest risk.

The study reviewed calls to four ambulance services in England (urban, rural, mixed and remote) between 1997 and 2001 involving almost 12 000 patients who were unconscious, not breathing or suffering chest pain. The final analysis included 10 315 patients for whom distance travelled could be calculated accurately ranging from zero to 58 kilometres with an average of 5 kilometres. A total of 644 (just over 6 per cent) died.

Researchers found that the further patients had to travel by ambulance, the more likely they were to die with the risk increasing by 1 per cent for every 10 kilometres.

After factoring in age, sex and severity of illness, patients with breathing problems were more at risk than those with chest pain, injuries, poisoning, or other types of trauma. This group had a13 per cent chance of dying if the distance to emergency care was 10 - 20 kilometres rising to 20 per cent for longer distances.

These findings have significant implications for the UK government's plans to close some accident and emergency departments based at local district general hospitals in favour of fewer specialist centres.

Researchers conclude:

"Our data suggest that any changes that increase journey distances to hospital for all emergency patients may lead to an increase in mortality for a small number of patients with life-threatening medical emergencies, unless care is improved."