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Ambulance diversion associated with reduced access to cardiac technology and increased one-year mortality.
Health Aff (Millwood). 2015 Aug; 34(8):1273-80.HA

Abstract

Ambulance diversion, which occurs when a hospital emergency department (ED) is temporarily closed to incoming ambulance traffic, is an important system-level interruption that causes delays in treatment and potentially lower quality of care. There is little empirical evidence investigating the mechanisms through which ambulance diversion might affect patient outcomes. We investigated whether ambulance diversion affects access to technology, likelihood of treatment, and ultimately health outcomes for Medicare patients with acute myocardial infarction in twenty-six California counties. We found that patients whose nearest hospital ED had significant ambulance diversions experienced reduced access to hospitals with cardiac technology. This led to a 4.6 percent decreased likelihood of revascularization and a 9.8 percent increase in one-year mortality compared to patients who did not experience diversion. Policy makers may wish to consider creating a policy to specifically manage certain time-sensitive conditions that require technological intervention during periods of ambulance diversion.

Authors+Show Affiliations

Yu-Chu Shen (yshen@nps.edu) is a professor of economics at the Graduate School of Business and Public Policy, Naval Postgraduate School, and a faculty research fellow at the National Bureau of Economic Research, in Monterey, California.Renee Y. Hsia is a professor in the Department of Emergency Medicine and Philip R. Lee Institute for Health Policy Studies at the University of California, San Francisco.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

26240239

Citation

Shen, Yu-Chu, and Renee Y. Hsia. "Ambulance Diversion Associated With Reduced Access to Cardiac Technology and Increased One-year Mortality." Health Affairs (Project Hope), vol. 34, no. 8, 2015, pp. 1273-80.
Shen YC, Hsia RY. Ambulance diversion associated with reduced access to cardiac technology and increased one-year mortality. Health Aff (Millwood). 2015;34(8):1273-80.
Shen, Y. C., & Hsia, R. Y. (2015). Ambulance diversion associated with reduced access to cardiac technology and increased one-year mortality. Health Affairs (Project Hope), 34(8), 1273-80. https://doi.org/10.1377/hlthaff.2014.1462
Shen YC, Hsia RY. Ambulance Diversion Associated With Reduced Access to Cardiac Technology and Increased One-year Mortality. Health Aff (Millwood). 2015;34(8):1273-80. PubMed PMID: 26240239.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ambulance diversion associated with reduced access to cardiac technology and increased one-year mortality. AU - Shen,Yu-Chu, AU - Hsia,Renee Y, PY - 2015/8/5/entrez PY - 2015/8/5/pubmed PY - 2017/1/17/medline KW - Access To Care KW - Ambulance Diversion KW - Patient Outcomes SP - 1273 EP - 80 JF - Health affairs (Project Hope) JO - Health Aff (Millwood) VL - 34 IS - 8 N2 - Ambulance diversion, which occurs when a hospital emergency department (ED) is temporarily closed to incoming ambulance traffic, is an important system-level interruption that causes delays in treatment and potentially lower quality of care. There is little empirical evidence investigating the mechanisms through which ambulance diversion might affect patient outcomes. We investigated whether ambulance diversion affects access to technology, likelihood of treatment, and ultimately health outcomes for Medicare patients with acute myocardial infarction in twenty-six California counties. We found that patients whose nearest hospital ED had significant ambulance diversions experienced reduced access to hospitals with cardiac technology. This led to a 4.6 percent decreased likelihood of revascularization and a 9.8 percent increase in one-year mortality compared to patients who did not experience diversion. Policy makers may wish to consider creating a policy to specifically manage certain time-sensitive conditions that require technological intervention during periods of ambulance diversion. SN - 1544-5208 UR - https://www.unboundmedicine.com/medline/citation/26240239/Ambulance_diversion_associated_with_reduced_access_to_cardiac_technology_and_increased_one_year_mortality_ L2 - https://www.healthaffairs.org/doi/10.1377/hlthaff.2014.1462?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -