Thousands of ambulances are turned away from overcrowded hospitals every year and diverted to other local hospitals. Diverted ambulances drive extra miles to a different hospital costing precious life-saving time for the patients inside.
The number of ambulance diversions each day continues to rise in response to the growing number of emergency room (ER) visits and the shrinking number of ERs in the country. In 2011 there were 131 million ER visits, or 42 visits for every 100 individuals, and numbers continue to grow. Furthermore, about a quarter of the ERs in the United States have permanently closed in the last 25 years.
ER visits rose by 10% between 2013 and 2014, and by another 20% between 2014 and 2015.Overcrowded ERs mean that ambulances are diverted to other hospitals at higher rates, and that patients lose valuable minutes of life-saving care.
A study of California hospitals between 2000 and 2006 found daily for an average of 8 hours a day, hospitals closed their doors to incoming ambulances. The study found no significant difference in mortality rates between areas with no ER diversion and areas with ER diversion times under 12 hours. But when hospitals experienced more than 12 hours of diversion time each day, patient mortality rates rose by almost 3.3% (a very significant number in the medical world).
Ambulances can be diverted to hospitals around the corner, or hospitals twenty minutes away. For some patients, that time can make all the difference.
A study by the Journal of the American Medical Association found that heart-attack patients were more likely to die within a year if their ambulances were diverted to another hospital. However, other studies found that ambulance diversions can also saves lives when patients are brought to overflowing ERs who will not be able to treat them.
States are trying a variety of approaches to ameliorate this problem. Several years ago, Massachusetts completely banned ambulance diversion. California took a different approach and called for mandatory ambulance diversion if a patient does not receive a hospital bed within 90 minutes.
One problem may be the overuse of ERs to handle various medical conditions.
A 2013 study by Truven Health Analytics found that only 29% of ER patients required immediate attention and 41% received care that could have been given by a primary care physician. 24% of ER patients did not require immediate attention, and 6% of visits could have been avoided with proper primary care.
Maryland in particular has a history of overcrowded ERs and high rates of ambulance diversion. One step patients can take is to get to know the hospitals around them. Patients who know which hospital has lower wait times and less crowded ERs may be able to request that hospital first. Most times though, patients will not have the opportunity to make this decision.
To read about average ER wait times for Maryland hospitals, click here.