We develop a conceptual framework and empirically investigate how a permanent emergency department (ED) closure affects patients with acute myocardial infarction (AMI). We first document that large increases in driving time to closest ED are more likely to happen in low-income communities and...

In order to better understand what threatens vulnerable populations' access to primary care, it is important to understand the factors associated with closing safety-net clinics. This paper examines how a clinic's financial position, productivity, and community characteristics are associated...

This study examines the effect of HMO and for-profit HMO share on the survival of safety net services and profitable services in hospitals. Using data from 1990-2003 and proportional hazard models, I find that hospitals in high HMO markets started out having lower hazard of shutting down...

In this paper we take a historical perspective to examine the effects of managed care and hospital competition on hospital cost and revenue growth during managed care’s boom period (1990-1994), mature period (1995-1999), and backlash period (2000-2003). We find that while higher managed care...