Steflovich Michael
University of Florida, American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten, Neth-erland Antilles. ORCID: https://orcid.org/0000-0001-7799-3010.
J Emerg Manag. 2023;21(7):203-212. doi: 10.5055/jem.0723.
Recent news has shown the strain on hospital emergency departments (EDs) and emergency medical services agencies due to the surge of COVID-19; however, compared to all emergency medical service transports, is it true that the United States is seeing an increase in the frequency of diversions? In this quantitative research report, data were collected and analyzed from a national prehospital emergency medical services information system, which allowed for a comparison of the frequency of diverted ambulances, transport times, and final patient acuity of patients arriving by diverted ambulances before and during the COVID-19 pandemic. Statistical analysis was performed on data obtained from the National Emergency Medical Services Information System to compare the frequency of ambulance diversion prior to the COVID-19 disaster and during COVID-19.
Analysis of data obtained from the National Emergency Medical Services Information System found that there was not a significant increase in the percentage of ambulance transports that were diverted during the COVID-19 pandemic compared to before the pandemic. However, there were significant increases in the volume of all transports and diverted transports during the COVID-19 pandemic (p < 0.01 for both measures).
The significant increases seen in the demand for services, combined with an overall downward trend in the number of healthcare facilities, have resulted in an increase in the volume of diversions, despite the overall demand increasing as well. The COVID-19 pandemic serves as a disaster/public health crisis that is subject to the same phases compared to other types of disasters. The significant findings of this report should provide the emergency services field a big picture, understanding that the problem at hand is multifaceted, with these findings shining light on the effects of current issues between emergency services and hospital EDs.
近期新闻显示，由于新冠疫情激增，医院急诊科（EDs）和紧急医疗服务机构面临压力；然而，与所有紧急医疗服务运输相比，美国转院频率真的在增加吗？在这份定量研究报告中，从一个全国性的院前紧急医疗服务信息系统收集并分析了数据，该系统允许比较新冠疫情之前和期间转院救护车的频率、运输时间以及通过转院救护车送达患者的最终病情严重程度。对从国家紧急医疗服务信息系统获得的数据进行了统计分析，以比较新冠疫情灾难之前和期间救护车转院的频率。
对从国家紧急医疗服务信息系统获得的数据进行分析发现，与疫情之前相比，新冠疫情期间转院的救护车运输百分比没有显著增加。然而，新冠疫情期间所有运输和转院运输的数量都有显著增加（两项指标的p值均<0.01）。
尽管总体需求也在增加，但服务需求的显著增加，加上医疗保健设施数量的总体下降趋势，导致了转院数量的增加。新冠疫情是一场灾难/公共卫生危机，与其他类型的灾难一样经历相同的阶段。本报告的重要发现应为紧急服务领域提供一个总体情况，让人们认识到手头的问题是多方面的，这些发现揭示了当前紧急服务与医院急诊科之间问题的影响。
