No Increase in LOS After Ambulance Diversion Ban

When Massachusetts imposed its first-in-the-nation statewide ban on ambulance diversions on Jan. 1, 2009 some providers voiced concerns that the policy would lead to longer emergency department wait times and delayed ambulance turnarounds.

A study shows that those concerns have not materialized.

In fact, the average ED wait time and ambulance turnaround dropped in the nine Boston-area hospitals whose records were reviewed in the study, which appeared this month in the online version of Annals of Emergency Medicine.

Researchers examined ED records for all of 2008, the year before the ban was imposed, and for 2009, using length of stay as the measure for crowding. The data showed that none of the nine hospitals' EDs saw an increase in length of stay for admitted or discharged patients, and there was no increase in ambulance turnaround time, despite an increase in overall ED patient traffic.

Overall, ED volume at the nine hospitals increased by 3.6% after the diversion ban but length of stay fell 10.4 minutes for admitted patients and ambulance turnaround time fell 2.2 minutes, the study found.

"For us, the key point was that times went down at all. We had heard that things were going relatively well but we wanted to approach it quantitatively," says study coauthor Laura G. Burke, MD, MPH, an emergency physician with Beth Israel Deaconess Medical Center in Boston.