How far is the nearest hospital, and when does it matter?

By Neil Solomon · 2 min read

Imagine you are at home and a heart attack begins. How many minutes would it take to reach a hospital?

A study in Tayside, Scotland followed 10,541 people who had a first heart attack between 1994 and 2003. Of them, 4,133 died before they were admitted to a hospital. The researchers compared those deaths with how far each person lived from the hospital.

Dying before reaching hospital, by distance from home (Tayside, Scotland)

Odds are adjusted for age, sex, deprivation, other health factors, rural or urban setting and travel time. The car time does not include the ambulance's arrival.

Compared with people living under 3 miles away, those over 9 miles away had about twice the odds of dying before admission. The range is wide, so the exact size is uncertain.

Distance made no difference once people were inside the hospital. The odds of dying in hospital were 0.95 for the farthest group, with a range of 0.45 to 2.03. The gap came before arrival.

A second study looked at 10,315 life-threatening emergencies taken to hospital by four English ambulance services. Each additional 10 kilometers in straight-line distance went with about 1% more deaths. Breathing emergencies showed the strongest link.

The link does not hold for every condition. A study of emergency abdominal surgery in England found no significant relationship between travel distance and death.

So distance seems to matter most when minutes count, as with a heart attack or a breathing emergency.

These studies have limits. Both are from public health systems in Britain, and the data are old. They watched what happened and did not test it, so other differences between near and far households may play a part. The Tayside authors could not say why distance mattered.

Most of the people in the Tayside study were older. The average age at heart attack was about 72.

Time by car to an emergency department is simple to check for any address. A question you could ask is how many minutes it takes, and whether that hospital treats heart attacks.

We looked for solid data on how fresh food markets affect long life and did not find enough to report here.

How many minutes is the nearest hospital from where you live? Tell us in the comments. Someone may be comparing addresses.

Sources we read

Wei and others, Impact on mortality following first acute myocardial infarction of distance between home and hospital, Heart, 2008. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564842/

Nicholl and others, The relationship between distance to hospital and patient mortality in emergencies, Emergency Medicine Journal, 2007. https://europepmc.org/api/getPdf?pmcid=PMC2464671

Distance travelled to hospital for emergency laparotomy and the effect of travel time on mortality: cohort study. https://pmc.ncbi.nlm.nih.gov/articles/PMC8070618