When the closest hospital to a patient experiencing acute myocardial infarction is in an ambulance diversion, it can lead to reduced access to hospitals with proper technology and ultimately an increase in one-year mortality, according to a study in Health Affairs.
Ambulance diversions happen when a hospital's emergency department is closed temporarily to incoming cases, due to issues like overcrowding or lack of available resources.
To study the effects these diversions have on patient outcomes, researchers used Medicare claims and daily ambulance diversion logs from 26 California counties between 2001 and 2011 and analyzed changes in access, treatment and outcomes for patients.
They found that when heart attack patients whose nearest hospital ED had a significant diversion, they experienced poorer access to hospitals with proper cardiac technologies, which in turn led to a 4.6 percent decreased likelihood of receiving treatment with revascularization and a 9.8 percent increase in one-year mortality.
"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," the study states.