title: Ambulance diversion is not associated with low acuity patients attending Perth metropolitan emergency departments.
abstract: OBJECTIVE
  To examine the relationship between ambulance diversion and low acuity patient (LAP) attendances to EDs.
  
  
  METHODS
  Comparison of LAP attendance rates at inner metropolitan EDs and outer metropolitan EDs using a previously validated methodology.
  
  
  RESULTS
  The percentage of LAP attendances was lower at inner metropolitan EDs (11.4%, 95% CI 11.3-11.6) compared to outer metropolitan hospitals (22.9%, 95% CI 22.6-23.2, P < 0.001). The proportion of LAP attendances was slightly higher at both inner and outer metropolitan hospitals after-hours compared to working hours. Average daily LAP attendances per inner metropolitan hospital (13.4 attendances, 95% CI 13.2-13.6) which averaged 89.2 min of diversion daily (95% CI 88.7-89.7) were lower than at outer metropolitan hospitals (19.3 attendances, 95% CI 19.0-19.6, P < 0.001), which averaged 12.4 min of diversion daily (95% CI 12.1-12.5, P < 0.001).
  
  
  CONCLUSIONS
  Inner metropolitan hospitals experience low LAP attendance rates. Attempts to further reduce LAP attendance rates at Perth inner metropolitan hospitals have limited scope to reduce ambulance diversion.
authors.affiliation: Acute Demand Management Unit, Department of Health, Western Australia, Australia. peter.sprivulis@health.wa.gov.au
authors.forename: Peter
authors.initials: P
authors.lastname: Sprivulis
authors.forename: Stephen
authors.initials: S
authors.lastname: Grainger
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Nagree
mesh_terms: D000328:Adult; D000552:Ambulances / Q000706:statistics & numerical data*; D002648:Child; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D010360:Patient Transfer / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D019036:Suburban Health Services / Q000706:statistics & numerical data; D014218:Triage / Q000706:statistics & numerical data; D014904:Western Australia