Breaking News: MI Patients Fare Worse When EDs on Divert
Abstract
ImageNew research involving more than 13,000 Medicare patients makes a strong case that ambulance diversion has a ripple effect greater than realized, extending beyond merely having to transport patients to another hospital. The study, done in four California counties, found that heart attack patients are more likely to die after admission when their nearest emergency department is on prolonged ambulance diversion. (JAMA 2011;305[23]:2440.) That association has long been suggested by anecdotal reports, and some small studies have found that patients can be harmed when ambulances are turned away due to ED crowding or other reasons. But this California study found three potentially avoidable deaths among every 100 heart attack patients, and not necessarily because they received untimely care in an ED, said the study's lead author, Yu-Chu Shen, PhD. “When a patient's nearest ED was exposed to diversion for 12 or more hours on the day of admission, the patient experiences a higher death rate by about 3 percentage points than when that same ED was not on diversion. This adverse relationship persisted when we examined the 1-year mortality rate,” the study said. When a hospital is on diversion, it can affect not only patients who are diverted, but those receiving care or admitted while the ED is diverting ambulances and those in hospitals receiving diverted patients, the study concluded. In all those scenarios, a patient might receive less-than-optimal care because resources are…
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