The number of hours each month that hospitals are diverting ambulances from their emergency departments is increasing as hospital closures and other hospitals' diversion status impact nearby EDs.
Researchers sampled all hospitals in Los Angeles County that have EDs and accept ambulances from 1998 to 2004. Of the 80 hospitals included in the study, nine closed during the study period.
ED diversion rates increased from an average of 57 hours in 1998 to an average of 190 hours in 2004. After a hospital closure, the average time nearby hospitals spent on diversion increased by 56 hours in the first four months after the closure.
Data indicate that, although Los Angeles County hospitals have been able to compensate for fewer ED beds, their ability to absorb patients from future hospital closures might be decreasing.
Researchers recommend that regulators "carefully scrutinize" further hospital closures because data show that ED crowding is related to reduced ED and hospital capacity rather than increased demand for treatment at EDs. The study also could provide a national model by which policymakers might anticipate the effects of hospital closures on ED crowding and ambulance diversion (Sun et al., Annals of Emergency Medicine," April 2006).