Is Inpatient Volume or Emergency Department Crowding a Greater Driver of Ambulance Diversion?
Hsia, Renee Y.
MetadataShow full item record
Inpatient volume has long been believed to be a contributing factor to ambulance diversion, which can lead to delayed treatment and poorer outcomes. We examined the extent to which both daily inpatient and emergency department (ED) volumes at specified hospitals, and diversion levels (that is, the number of hours ambulances were diverted on a given day) at their nearest neighboring hospitals, were associated with diversion levels in the period 2005–12. We found that a 10 percent increase in patient volume was associated with a sevenfold greater increase in diversion hours when the volume increase occurred among inpatients (5 percent) versus ED visitors (0.7 percent). When the next-closest ED experienced mild, moderate, or severe diversion, the study hospital’s diversion hours increased by 8 percent, 23 percent, and 44 percent, respectively. These findings suggest that efforts focused on managing inpatient volume and flow might reduce diversion more effectively than interventions focused only on ED dynamics.
The article of record as published may be found at http://dx.doi.org/10.1377/hlthaff.2017.1602
RightsThis 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.
Showing items related by title, author, creator and subject.
Impact of ambulance diversion: black patients with acute myocardial infaraction had higher mortality than whites Hsia, Renee Y.; Sarkar, Nandita; Shen, Yu-Chu (Health Affairs, 2017-06);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 ...
Do patients hospitalised in high-minority hospitals experience more diversion and poorer outcomes? A retrospective multivariate analysis of Medicare patients in California Shen, Yu-Chu; Hsia, Renee Y (2016);Objective: We investigated the association between crowding as measured by ambulance diversion and differences in access, treatment and outcomes between black and white patients. Design: Retrospective analysis. Setting: ...
Tan Soon; Meng Alvin (Monterey, California. Naval Postgraduate School, 2007-06);Pressure on emergency medical services (EMS) is rising. The growth in EMS utilization has coincided with a decline in the number of emergency departments (ED). Between 1994 and 2004, the annual number of ED visits in the ...