Publication:
Impact of ambulance diversion: black patients with acute myocardial infaraction had higher mortality than whites

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Authors
Hsia, Renee Y.
Sarkar, Nandita
Shen, Yu-Chu
Subjects
Advisors
Date of Issue
2017-06
Date
Publisher
Health Affairs
Language
Abstract
This study investigated whether emergency department crowding affects blacks more than their white counterparts and the mechanisms behind which this might occur. Using a nonpublic database of patients in California with acute myocardial infarction between 2001 and 2011 and hospital-level data on ambulance diversion, we found that hospitals treating a high share of black patients with acute myocardial infarction were more likely to experience diversion and that black patients fared worse compared to white patients experiencing the same level of emergency department crowding as measured by ambulance diversion. The ninety-day and one-year mortality rates among blacks exposed to high diversion levels were 2.88 and 3.09 percentage points higher, respectively, relative to whites, representing a relative increase of 19 percent and 14 percent for ninety-day and one-year death, respectively. Interventions that decrease the need for diversion in hospitals serving a high volume of blacks could reduce these disparities.
Type
Article
Description
The article of record as published may be located at http://dx.doi.org/10.1377/hlthaff.2016.0925
Series/Report No
Department
Business & Public Policy (GSBPP)
Other Units
Naval Postgraduate School (U.S.)
Identifiers
NPS Report Number
Sponsors
National Institutes of Health and the National Heart, Lung, and Blood Institute
American Heart Association
Funder
1R01HL114822
13CRP14660029
Format
8 p.
Citation
Renee Y. Hsia, Nandita Sarkar, Yu-Chun Shen "Impact of ambulance diversion: black patients with acute myocardial infaraction had higher mortality than whites."Health Aff June 2017 vol. 36 no. 6 1070-1077.
Distribution Statement
Rights
This publication is a work of the U.S. Government as defined in Title 17, United States Code, Section 101. Copyright protection is not available for this work in the United States.
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