Analysis of Ambulance Transports & Diversions Among US E

[Ridryder 911]

I found an interesting article relating to EMS diversions and current trends of EMS and ER numbers. Sorry, I can't post whole article due to copyright, and the link is also a paid site. I will quote portion's, I thought was interesting facts:

Annals of Emergency Medicine: Volume 4, Issue 17; April 2006, Pages 317-326

"Study objective

We describe emergency department (ED) visits in which the patient arrived by ambulance and estimate the frequency of and reasons for ambulance diversion. Using information on volume of transports and probabilities of being in diversion status, we estimate the number of patients for whom ED care was delayed because of diversion practices"

How it was performed:

Data was from the 2003 ED component of the National Hospital Ambulatory Medical Care Survey, an annual sample survey of visits to US hospital EDs, were used for the analysis. Data were provided by 405 participating EDs on 40,253 visits. Data from supplemental questionnaires to the hospital staff were used to describe volume and frequency of ambulance diversions.

Results

In 2003, patients arrived by ambulance for 16.2 million ED visits (14.2%). About 31 ambulances arrived at a US ED every minute. Of ambulance-related visits, 39% were made by seniors, 68% were triaged as emergent or urgent, and 37% resulted in hospital-admission. About 45% of EDs reported diverting ambulances at some point during the previous year. Among EDs that had any diversion, approximately 3% of operating time was spent in diversion status. In 2003, an estimated 501,000 ambulances were diverted, ie, 1 ambulance diversion per minute. Large EDs represent 12% of all EDs, 35% of all ambulance arrivals, 18% of all EDs that went on diversion, 47% of all hours spent in diversion status, and 70% of all ambulances diverted to another ED

Conclusion : was the need of importance of study for next 15 years. "

I thought this was interesting in the fact the number of EMS responses to ER's. The triage was placed in high categories "68% were triaged as emergent or urgent" in comparison of only "37% being admitted". Is this due to treatment alleviating the existing emergency s/p or is it over triage syndrome from field and ER staff ? I am surprised that approx 1/2 million EMS units were diverted to an ER and apparently no-one is really taking notice of this yet. By the response of the conclusion was to continuing studying, and working to decrease this in the future. That's it ?... Nice identify a problem, without any more suggestions than that... ?

It appears to me ACEP might be like the old saying.. see no evil, hear no evil, tell no evil...At least on their side they are recognizing it.. now doing something about it is another problem.

Open the discussion up, is this a major problem in your area, how does your system deal with this, and what do you see or predict in the future and remedies?

R/R 911

[fanbuffett]

yeah try getting diverted while pulling in there driveway after trying to raise them on the radio and land line for 15 min. sorry but thay got them anyway.

it is amazing how often it happens but the general public has no ideal how serious it really is