RWJF Content Alert--Ambulance Diversion Increases Deaths

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Study Shows Increased Mortality for AMI Patients When Local Emergency Department is on Diversion

A new, first-of-its kind study used Medicare claims and daily ambulance diversion logs from the local emergency medical services of four California counties to analyze the consequences of ambulance diversion (the situation in which emergency departments are not accepting ambulance traffic) on the short- and long-term mortality rates for patients suffering acute myocardial infarction (AMI), or heart attack. Researchers at the Naval Postgraduate School in Monterey, Calif., found that patients whose nearest emergency department (ED) was on divert for 12 or more hours on the day they suffered AMI, had a mortality rate 2.8 percentage points higher than those patients whose nearest ED was not on divert the day of their heart attack.

Published in the Journal of the American Medical Association (JAMA), the research included data for nearly 14,000 Medicare patients living in four California counties who experienced a heart attack from 2000–2005. Prior to this study, most research on ambulance diversion focused on how to decrease diversion hours rather than on patient care or outcomes. The little outcomes research that did exist was largely anecdotal or focused on a single site only, while this research included 149 California EDs.

The research was funded by the Robert Wood Johnson Foundation’s Changes in Health Care Financing and Organization initiative, which is administered by AcademyHealth.
 

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