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The relationship between distance to hospital and patient mortality in emergencies: an observational study
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  • Published on:
    Response to Ashton et al
    • Jon Nicholl
    • Other Contributors:
      • James West, Steve Goodacre, Janette Turner


    Ashton and colleagues are of course right that it is time to hospital that is critical to outcome not distance, and that distance can be a poor proxy for time especially in urban areas. Nevertheless, for the purpose of research we would advocate using distance rather than time, since the former is fixed and objective, but the latter is not well defined, variable, and prone to recording errors. It is varia...

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    Conflict of Interest:
    None declared.
  • Published on:
    The importance of journey times to hospital in urban areas
    • Charlotte E Ashton, Specialty Registrar in Public Health
    • Other Contributors:
      • Maggie Harding and Jacqueline Lindo

    Sir, we found Nicholl et al’s findings on distance to hospital and patient mortality in emergencies both interesting and highly topical. Although the authors justify the use of straight-line ambulance distance opposed to journey times, in urban/inner city areas time to hospital may be a more relevant factor. For instance in Sutton and Merton PCT all general practices have one accident and emergency department within 5km,...

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    Conflict of Interest:
    None declared.