Study Looks at Hospital Diversions and Minority Populations - News - @ JEMS.com


Study Looks at Hospital Diversions and Minority Populations

Researchers looked at over 200 hospitals in California


 
 

India Pharma News | | Thursday, October 25, 2012


Hospitals in areas with large minority populations are more likely to be overcrowded and to divert ambulances, delaying timely emergency care, according to a multi-institutional study focused on California.

The researchers examined ambulance diversion in more than 200 hospitals around the state to assess whether overcrowding in emergency rooms disproportionately affects racial and ethnic minorities. They found that minorities are more at risk of being impacted by ER crowding and by diversion than non-minorities.

The study will be published in the August issue of Health Affairs.

"Our findings show a fundamental mismatch in supply and demand of emergency services,'' said lead author Renee Y. Hsia, MD, assistant professor of emergency medicine at UCSF. She is also an attending physician in the emergency department at San Francisco General Hospital & Trauma Center.

"If you pass by a closer hospital that is on diversion for a hospital 15 minutes down the road, you are increasing the amount of time the patient is in a compromised situation," Hsia said. "It puts these patients at higher risk for bad health outcomes from conditions like heart attacks or stroke, where minutes could mean the difference between life and death.''

Ambulance diversion is triggered when a hospital's emergency department is too busy to accept new patients - ambulances are rerouted to the next available ER, sometimes miles away. It is especially common in urban areas, particularly in recent years as demand for emergency care has risen.

This is the first study using hospital-level data to show how diversion affects minorities, the authors said.

The scientists looked at emergency departments at all of California's acute, nonfederal hospitals operating in 2007. Pediatric hospitals were excluded because they typically do not treat adults, as well as hospitals in counties that forbid the practice of ambulance diversion. Altogether, the study involved 202 hospitals in 20 counties where diversion is permitted - the majority of them are not-for-profit facilities.

In all, 92 percent of the hospitals were on diversion for a median of 374 hours over the course of the year. Those serving high numbers of minorities were on ambulance diversion for 306 hours compared to 75 hours at hospitals with fewer minority patients.

"Because ambulances typically transport patients needing true emergency care, diversion reroutes the neediest patients away from their nearest hospital, representing a failure of the systems to provide the intended care,'' the authors wrote.

Some limitations to the study were noted: Diversion is an imperfect measure of overcrowding, and even when an emergency department is on diversion status, certain patients - particularly trauma patients - still can be accepted. Additionally, the study looked solely at California hospitals.

"Emergency departments and trauma centers are closing more frequently in areas with vulnerable populations, including racial and ethnic minorities,'' Hsia said. "This is a systems-level health disparities issue that requires changing the 'upstream' determinants of access to emergency care. It's not just a problem at the level of the emergency department itself, but of the hospital and entire system."

The authors say their research points to the need for systemic reform, including better management of hospital flow and statewide criteria regulating diversion policies.

Co-authors are Steven M. Asch, MD, MPH, Robert E. Weiss, PhD, David Zingmond, MD, PhD, Li-Jung Liang, PhD, Weijuan Han, MS, and Heather McCreath, PhD of UCLA; and senior author Benjamin C. Sun, MD, of Oregon Health and Science University.

The study was funded by the Emergency Medicine Foundation, the Agency for Healthcare Research and Quality, UC Los Angeles, Older Americans Independence Center, and the Robert Wood Johnson Foundation Physician Faculty Scholars program.

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.



Copyright © 2013 LexisNexis, a division of Reed Elsevier Inc. All rights reserved. Terms and Conditions | Privacy Policy


Connect: Have a thought or feedback about this? Add your comment now
Related Topics: News, hospital diversion

What's Your Take? Comment Now ...

Buyer's Guide Featured Companies

Featured Careers & Jobs in EMS

Get JEMS in Your Inbox

 

Fire EMS Blogs


Blogger Browser

Today's Featured Posts

 

EMS Airway Clinic

Improving Survival from Cardiac Arrest Using ACD-CPR + ITD

Using active compression-decompression CPR with an ITD has been shown to improve 1-year survival from cardiac arrest by 33%.
More >

Multimedia Thumb

Philadelphia Fire Department Apologizes for Medic’s Jab at Police

Union head calls photos a slap in the face of officers.
Watch It >


Multimedia Thumb

D.C. Fire and EMS Crews Blame New Technology for Patient’s Death

Delayed response blamed on recurring dispatch problems.
Watch It >


Multimedia Thumb

Suspect Steals, Crashes Maryland Ambulance

One killed, others injured in Prince George’s County crash.
Watch It >


Multimedia Thumb

Truck Strikes Pedestrians in Scotland

Six killed in downtown Glasgow.
More >


Multimedia Thumb

Tennessee Trench Rescue

Worker pulled from Roane County worksite.
More >


Multimedia Thumb

Time’s Ebola Firefighters

Doctors, nurses and others saluted for fighting virus.
More >


Multimedia Thumb

Braun Ambulances' EZ Door Forward

Helps to create a safer ambulance module.
Watch It >


Multimedia Thumb

LMA MAD Nasal™

Needle-free intranasal drug delivery.
Watch It >


Multimedia Thumb

VividTrac offered by Vivid Medical - EMS Today 2013

VividTrac, affordable high performance video intubation device.
Watch It >


More Product Videos >