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California hospitals may divert ambulances to avoid treating underserved populations, study suggests

Hospitals in California may be strategically diverting ambulances to avoid treating low-income patients typically served by public hospitals, suggest the findings of a study cited by the Milwaukee Journal Sentinel.

For the study, researchers reviewed ambulance diversion logs, discharge data and other characteristic data for 28 private and 16 public hospitals in California in 2007.

They found hospitals are 3.6 percent more likely to declare an ambulance diversion if nearby hospitals are public. Hospitals that declared an ambulance diversion after the diversion of a neighboring public hospital were more likely to have fewer patients in the emergency department than when diverting ambulances after a private hospital declares a diversion.

"The difference in sequential diversion may be occurring because hospitals wish to avoid serving more uninsured and Medicaid patients," study authors concluded. "Given the potential impact of the observed differences on health outcomes, there may be opportunity for interventions at the local, state and federal levels to improve the current structures influencing hospital diversion."

Editor's note: This article was updated May 13 at 2:03 p.m. to clarify that the Milwaukee Journal Sentinel received a copy of the study ahead of its publication in the Health Serives Research Journal.

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