Study confirms increased heart attack deaths in NYC ambulance ...( Ambulance diversions from nearby cro...),Health

Ambulance diversions from nearby, crowded New York emergency rooms to more distant emergency departments are associated with increased deaths among patients suffering from heart attacks, according to a paper presented at a meeting of the Institute for Operations Research and the Management Sciences (INFORMS).

"No Room at the Emergency Room: Causes and Consequences" was presented by Linda Green, an operations researcher who is the Armand G. Erpf Professor of the Modern Corporation at Columbia Business School. Co-authors are Sherry Glied, M. Grams, and Natalia Yankovic of Columbia University.

"Emergency room overcrowding and ambulance diversions aren't just inconvenient for patients," says Prof. Green. "This research shows that delaying treatment to people suffering ailments or injuries that require immediate care can cost them their lives."

Patients who try to access a hospital emergency room during a time of ambulance diversion may experience additional delays not only due to the increased travel time associated with going to a more distant hospital, but also because this increased time translates into longer response times to calls for ambulances. In addition, the research showed that when one hospital is on diversion, there is an increased likelihood that other hospitals are on diversion and so emergency rooms are generally busier. So when the patient arrives to an emergency room, the wait to be seen by a physician and receive care is likely to be longer.

The authors studied data collected in all five boroughs of New York City in 1999 and 2000. They found a significant association between time on ambulance diversion and increased mortality resulting from acute myocardial infarction (AMI). Each additional borough-hour of ambulance diversion was associated with a 2.9 to 3.8% increase in AMI outpatient deaths. Days which had an incidence of gridlock, which was defined as at least 25% of hospitals in a borough being on diversion simultaneously, w
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