Hostname: page-component-745bb68f8f-mzp66 Total loading time: 0 Render date: 2025-01-11T01:22:05.928Z Has data issue: false hasContentIssue false
  • English
  • Français

Patient Distribution of an Urban-Rural Emergency Medical Services System

Published online by Cambridge University Press:  28 June 2012

Michael S. Jastremski  and
Ronald J. Lagoe
Michael S. Jastremski*
Affiliation:
Director, Program in Emergency and Critical Care Medicine, University Hospital SUNY–Syracuse, Syracuse, N.Y.
Ronald J. Lagoe
Affiliation:
Executive Director, Hospital Executive Council, Syracuse, N.Y.
*
Michael S. Jastremski, MD, Director, Program in Emergency and Critical Care, SUNY–Syracuse, Health Science Center at Syracuse, 750 East Adams Street, Syracuse, NY 13210
Get access Rights & Permissions [Opens in a new window]

Abstract

This study describes a series of mechanisms to alleviate overcrowding of hospital emergency departments by distributing critically ill patients among facilities with available resources. The initial mechanism, which was based on the availability of critical care beds, was used successfully between 1982 and 1986, but had to be abandoned when several new factors caused the availability of emergency department resources to become the limiting factor. A second approach, based on the availability of critical care and emergency department resources, produced limited success over a one-year period. The system currently in use, implemented in 1989, includes a distribution system based on the availability of emergency department resources and critical care beds, as well as a mechanism for diversion of ambulances to hospitals in neighboring counties at times of extremely high utilization. This experience demonstrates that mechanisms for planning the distribution of emergency and critically ill patients have universal applicability.

Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 5 , Issue 2 , June 1990 , pp. 119 - 129
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Gibson, G: Patterns and trends of utilization of emergency medical services. In Schwartz, GR, Safar, P, Stone, JH, et al (eds): Principles and Practice of Emergency Medicine. Philadelphia, W.B. Saunders Co., 1978, p. 1513.Google Scholar
2. American Hospital Association: 1988 Hospital Statistics. Chicago, III., American Hospital Association, 1988, p. 20.Google Scholar
3. Mayer, JB: Emergency medical service: Delays, response time and survival. Medical Care 1979;17:818–827.CrossRefGoogle ScholarPubMed
4. Neville, N, Rowand, RS: Short stay unit solves emergency overcrowding. Dimensions in Health Service 1983;60:26–27.Google ScholarPubMed
5. Crump, JM, Laneve, L: Effects of ICU bed availability on outcome in the critically injured. Crit Care Med 1989;17:S43.Google Scholar
6. Geyman, JP: Trends and concerns in emergency room utilization. J Fam Pract 1980; 11:23–24.Google Scholar
7. Kalb, PE, Miller, DH: Utilization strategies for intensive care units. JAMA 1989; 261:2389–2395.CrossRefGoogle ScholarPubMed
8. Ettinger, WG, Casani, JA, Coon, PJ, Muller, DC, Piazza-Appel, K: Patterns of use of the emergency department by elderly patients. J Gerontol 1987;42:638–642.CrossRefGoogle ScholarPubMed
9. Andren, KG, Rosenqvist, U: Heavy users of an emergency department: a two year followup-up study. Soc Sci Med 1987;7:825–831.Google Scholar
10. Cales, RH, Anderson, PG, Heilig, RW: Utilization of medical care in Orange County: The effect of implementation of a regional trauma system. Ann Emerg Med 1985;14:853–858.CrossRefGoogle ScholarPubMed
11. Cross, RE: Utilization patterns in a categorization system: Are the concerns real or imagined? J Am Coll Emerg Physicians 1979;8:284–286.Google Scholar
12. New York State Department of Commerce, State Data Center, Official Population Projections for New York State Counties. Albany, New York State Department of Commerce, State Data Center, 1985.Google Scholar
13. Central New York Health Systems Agency, Medical Facilities Plan for Central New York, 1986–1988. Syracuse, New York, Central New York Health Systems Agency, pp. 11–14.Google Scholar
14. U.S. Department of Health and Human Services, Public Health Service. Health, United States, 1987. Hyattsville, Md., U.S. Department of Health and Human Services, 1988, p. 138.Google Scholar
15. Lagoe, RJ, Milliren, JW: A community-based analysis of ambulatory surgery utilization. Am J Pub Health 1986;76:150–153.Google Scholar