The Effects of Ambulance Diversion: A Comprehensive Review
Article first published online: 28 JUN 2008
© 2006 Society for Academic Emergency Medicine
Academic Emergency Medicine
Volume 13, Issue 11, pages 1220–1227, November 2006
How to Cite
Pham, J. C., Patel, R., Millin, M. G., Kirsch, T. D. and Chanmugam, A. (2006), The Effects of Ambulance Diversion: A Comprehensive Review. Academic Emergency Medicine, 13: 1220–1227. doi: 10.1197/j.aem.2006.05.024
- Issue published online: 28 JUN 2008
- Article first published online: 28 JUN 2008
- Received March 2, 2006; Received Revised May 8, 2006; Received Revised May 12, 2006; Accepted May 13, 2006
- emergency service;
- emergency medical services;
- emergency medicine;
To review the current literature on the effects of ambulance diversion (AD).
The authors performed a systematic review of AD and its effects. PubMed, EMBASE, the Cochrane database, societal meeting abstracts, and references from relevant articles were searched. All articles were screened for relevance to AD.
The authors examined 600 citations and reviewed the 107 articles relevant to AD. AD is a common occurrence that is increasing in frequency. AD is associated with periods of emergency department (ED) crowding (Mondays, mid-afternoon to early evening, influenza season, and when hospitals are at capacity). Interventions that redesign the AD process or that provide additional hospital or ED resources reduce diversion frequency. AD is associated with increased patient transport times and time to thrombolytics but not with mortality. AD is associated with loss of estimated hospital revenues. Short of anecdotal or case reports, no studies measured the effect of AD on ED crowding, morbidity, patient and provider satisfaction, or EMS resource utilization.
Despite its common use, there is a relative paucity of studies on the effects of AD. Further research into these effects should be performed so that we may understand the role of AD in the health system.