Predicting Ambulance Diverson

Predicting Ambulance Diverson

Abey Kuruvilla (University of Wisconsin Parkside, USA) and Suraj M. Alexander (University of Louisville, USA)
DOI: 10.4018/978-1-60960-561-2.ch422

Abstract

The high utilization level of emergency departments in hospitals across the United States has resulted in the serious and persistent problem of ambulance diversion. This problem is magnified by the cascading effect it has on neighboring hospitals, delays in emergency care, and the potential for patients’ clinical deterioration. We provide a predictive tool that would give advance warning to hospitals of the impending likelihood of diversion. We hope that with a predictive instrument, such as the one described in this article, hospitals can take preventive or mitigating actions. The proposed model, which uses logistic and multinomial regression, is evaluated using real data from the Emergency Management System (EM Systems) and 911 call data from Firstwatch® for the Metropolitan Ambulance Services Trust (MAST) of Kansas City, Missouri. The information in these systems that was significant in predicting diversion includes recent 911 calls, season, day of the week, and time of day. The model illustrates the feasibility of predicting the probability of impending diversion using available information. We strongly recommend that other locations, nationwide and abroad, develop and use similar models for predicting diversion.
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Literature Review

A study of the literature shows that the rising trend in ambulance diversions started causing concern during the late 1980s (Richardson, Asplin, & Lowe, 2002), resulting in reports, position papers and task forces studying this problem from the early 1990s (Frank, 2001; Vilke, Simmons, Brown, Skogland, & Guss, 2001; Pham, Patel, Millin, Kirsch, & Chanmugam, 2006). However, owing to the elevated utilization level of EDs, ambulance diversion continues to be an issue today and is a common and increasing event that delays emergency medical care (Redelmeier et al., 1994).

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