Ambulance Diversion Associated With Reduced Access To Cardiac Technology And Increased One-Year Mortality
Hsia, Renee Y.
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Ambulance diversion, where emergency departments (ED) are temporarily closed to ambulance traffic, is an important system-level interruption that causes delays in treatment and potentially decreased quality of care. There is little empirical evidence investigating the mechanisms through which ambulance diversion might affect patient outcomes, however. We investigated whether ambulance diversion affects access to technology, likelihood of treatment, and ultimately health outcomes for patients with acute myocardial infarction. We found that patients whose nearest hospital experiences significant diversion indeed have reduced access to hospitals with cardiac technology. This leads to a 4.6% decreased likelihood of revascularization and a 9.8% increase in 1-year mortality. Policymakers may consider creating targeted policies to specifically manage certain time-sensitive conditions requiring technological intervention during periods of ambulance diversion.
Health Aff (Millwood) Author manuscript; available in PMC 2016 Aug 1The article of record as published may be found at http://dx.doi.org/10.1377/hlthaff.2014.1462
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