Management of emergency department diversion during the COVID-19 pandemic and disaster periods.

Abstract

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.