Emergency Department Closures and Patient Outcomes: Scoping Review of Impacts on Care, Equity, and System Performance
Abstract
Introduction: Emergency department (ED) closures have become increasingly common across health systems worldwide, reflecting mounting pressures from staffing shortages, resource constraints, and rising patient demand. Closures, whether temporary or permanent, pose potential risks to timely access to emergency care and may significantly impact patient outcomes and healthcare system performance. Despite growing attention from policymakers and the public, academic evidence on real-world impacts of ED closures remains fragmented. In this scoping review we compiled and summarized the current literature directly addressing the impacts of ED closures.
Methods: Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews criteria, we conducted a search of PubMed.gov, the Cumulative Index to Nursing and Allied Health Literature, and Web of Science databases for papers published in English after the year 2000 that directly addressed ED closures. We screened these papers by title and abstract. This search yielded 15 studies for which we then conducted a forward and backward citation search, ultimately producing 22 unique papers. Data from these papers were initially extracted into a spreadsheet and then organized into thematic tables based on the impacts they discussed.
Results: Our search yielded 1,725 papers, and we ultimately included 22 of these (1.3%). Most studies were observational or quasi-experimental, covering 147 unique ED…
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