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MCHP has been monitoring the effects of bed closures since downsizing began in 1992/93. The most recent study covers from 1989 (before any major bed closures) to 1996/97 or, where available, to 1997/98. 9
Previous analyses did not reveal any adverse effects of bed closures on system-wide measures of quality of care. As before, the following measures were used: 
Access to hospital services - measured by number of patients treated, types and amount of services provided, and length of stay, and location of service (inpatient or outpatient).
Quality of care - looked for indications that patients were sent home quicker and sicker from hospital (readmission and mortality rates).
Health of Population - analyzed mortality rates, especially among poor and elderly.
Generally, the results show that hospitals have responded remarkably well to the challenges of downsizing by adopting new ways of delivering care.