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patient care
management
assessment

Emergency department ambulance diversion: a thing of the past?

01 March 2012
Features
02 March 2012
Volume 2 · Issue 1

Emergency department (ED) overcrowding negatively impacts overall quality of care and limits emergency systems' capacity to effectively manage unanticipated surges in demand for medical care secondary to mass casualty incidents or pandemics (Bernstein et al, 2009; Agency for Healthcare Research and Quality, 2004). Given its pervasiveness across many emergency systems in the United States, ED overcrowding is now recognized as a key public health issue (Institute of Medicine, 2006).

Over the last two decades, as a result of increasing financial pressure, hospitals have decreased the total number of inpatient beds and eliminated spare capacity (DeLia and Wood, 2008). In addition, hospitals have increasingly focused on elective admissions with typically higher financial margins. These factors, combined with increasing demand for inpatient services, has led to higher hospital occupancy rates and less inpatient bed availability for admitted ED patients (Bazzoli et al, 2003; Schafermeyer and Asplin, 2003). This trend is expected to persist given the current economic climate and ongoing efforts to reduce costs by Medicare, Medicaid, and private payers.

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