Minority Patients at Higher Risk of Having Ambulances Diverted

California researcher says rerouting to other ERs can harm patients' health

Topics: Emergencies / First Aid Health Care Access / Disparities

MONDAY, Aug. 6 (HealthDay News) -- Emergency rooms in areas with large minority populations are more likely to divert ambulances to other hospitals due to overcrowding, according to a new study.

When ambulances are rerouted, the next available emergency room could be miles away. As a result, minority patients may not receive the timely medical care they need, said researchers at the University of California, San Francisco.

"Our findings show a fundamental mismatch in supply and demand of emergency services," study author Dr. Renee Hsia, an assistant professor of emergency medicine at UCSF and attending physician in the emergency department at San Francisco General Hospital & Trauma Center, said in a university news release. "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. 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."

The researchers analyzed ambulance diversion in 202 California hospitals in counties that allow ambulances to be diverted. Most were not-for-profit facilities.

Over the course of a year, hospitals in areas with large minority populations were on ambulance diversion for 306 hours. In contrast, hospitals with fewer minority patients diverted ambulances for 75 hours.

"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 researchers wrote.

They pointed out, however, that certain patients, such as those with traumatic injuries, can still be accepted by hospitals even when they are on diversion. Nonetheless, they concluded, system reform is needed to improve hospital flow management and the regulation of diversion policies.

"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 study appears in the August issue of the journal Health Affairs.

More information

Visit the U.S. National Institutes of Health to learn more about health disparities.

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