{"id":8747,"date":"2011-06-13T15:35:04","date_gmt":"2011-06-13T19:35:04","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?p=8747"},"modified":"2011-07-19T17:44:23","modified_gmt":"2011-07-19T21:44:23","slug":"increased-mortality-found-in-mi-patients-during-ambulance-diversion","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2011\/06\/13\/increased-mortality-found-in-mi-patients-during-ambulance-diversion\/","title":{"rendered":"Increased Mortality Found in MI Patients During Ambulance Diversion"},"content":{"rendered":"<p>MI patients who are diverted to other emergency departments (EDs) while their local EDs are closed have an increased risk for death, according to<a href=\"http:\/\/jama.ama-assn.org\/content\/early\/2011\/06\/07\/jama.2011.811.full\"> a new study published in <em>JAMA<\/em><\/a>. Yu-Chu Shen and Renee Hsia analyzed data on all Medicare patients with MI from four California counties who were admitted to the hospital between 2000 and 2005.<\/p>\n<p>At 1 year, the rates of death were:<\/p>\n<ul>\n<li>nearest ED not on diversion: 29%<\/li>\n<li>nearest ED &lt;6 hours on diversion on the date of admission: 31%<\/li>\n<li>nearest ED 6 to &lt; 12 hours on diversion on the date of admission: 30%<\/li>\n<li>nearest ED 12 or more hours on diversion on the date of admission: 35%<\/li>\n<\/ul>\n<p>The investigators found several differences of potential importance among the hospitals. For example, the hospitals that received the diverted patients were less likely to have a catheterization laboratory and were more likely to be either a for-profit hospital or a government hospital.<\/p>\n<p>In their conclusion, the authors point out that &#8220;diversion is a signal of a larger access problem in the health care system, representing resource constraints that are beyond patient factors and related to the hospital and health care system.&#8221; Their results, they write, &#8220;suggest that more integrated health care policies from the prehospital to in-hospital setting should include provisions that minimize instances in which hospitals are on diversion for prolonged periods.&#8221;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>MI patients who are diverted to other emergency departments (EDs) while their local EDs are closed have an increased risk for death, according to a new study published in JAMA. Yu-Chu Shen and Renee Hsia analyzed data on all Medicare patients with MI from four California counties who were admitted to the hospital between 2000 [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,9],"tags":[875,873,874,245],"class_list":["post-8747","post","type-post","status-publish","format-standard","hentry","category-general","category-interventional-cardiology","tag-ambulance-diversion","tag-eds","tag-hospital-delays","tag-mi"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/8747","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=8747"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/8747\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=8747"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=8747"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=8747"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}