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Ambulance diversion and patient outcomes

There are many factors that contribute to emergency department (ED) capacity constraints that result in ambulance diversions (see Hospital Capacity and Emergency Department Diversion: Four Community Case Studies). A study published this week in JAMA explores the association between ambulance diversion and increased mortality rates for acute myocardial infarction (AMI).

Analyzing data from four counties in California, the study measures the percentage of patients with AMI who died within 7 days, 30 days, 90 days, 9 months, and 1 year from admission (when their nearest ED was not on diversion and when that same ED was exposed to diversion at specified intervals). Researchers found that at least 12 hours of diversion by the nearest ED was associated with increased 30-day, 90-day, 9-month, and 1-year mortality.

Sources:

Shen, Y. C., and Hsia, R. Y. Association between ambulance diversion and survival among patients with acute myocardial infarction. JAMA. 305(23): 2440-2447, June 15, 2011. http://jama.ama-assn.org/content/305/23/2440.abstract

The Lewin Group. Hospital Capacity and Emergency Department Diversion: Four Community Case Studies. Chicago: American Hospital Association, 2004. http://www.aha.org/aha/content/2004/PowerPoint/EDDiversionSurvey040421.ppt

Posted by the AHA Resource Center (312) 422-2050, rc@aha.org.

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