title: Modeling the emergency ambulance pass-by of small rural hospitals in Victoria, Australia.
abstract: BACKGROUND
  Many small rural hospitals struggle to attract sufficient numbers of suitable patients. Inadequate patient throughput threatens the viability of these hospitals and, consequently, the financial, physical, and social well-being of the whole community. Anecdotal evidence suggests that many emergency ambulance patients are routinely taken past their local small rural hospital to the area's major receiving hospital.
  
  
  OBJECTIVE
  To quantify the ambulance pass-by of local small rural hospitals and identify the factors that influence its occurrence.
  
  
  METHODS
  Data were collected from the ambulance and hospital records of 3 small rural centers in central Victoria, Australia.
  
  
  RESULTS
  Ambulances transport a significant number of patients past their local small rural hospitals to the area's major receiving hospital. This takes less time for paramedics than bringing a patient to the local hospital first if the patient is then redirected by that hospital to the larger hospital. There is an inverse relationship between the rate of cases in which the local hospital redirects ambulances to the regional hospital and the rate of ambulance crew decisions to use the local hospital.
  
  
  CONCLUSIONS
  If some patients are being transported directly to the major receiving hospital because paramedics are considering their own time commitments when making patient transport decisions, this could have revenue implications for rural hospitals. Attracting appropriate local ambulance patients to the smaller hospitals may provide an income source that is currently lost to the crowded major receiving hospital's emergency department.
authors.affiliation: School of Public Health, LaTrobe University, Bundoora, Australia. pgleeson@iprimus.com.au
authors.forename: Patrick
authors.initials: P
authors.lastname: Gleeson
authors.forename: Stephen
authors.initials: S
authors.lastname: Duckett
mesh_terms: D000552:Ambulances / Q000592:standards / Q000706:statistics & numerical data* / Q000600:supply & distribution; D004636:Emergency Service, Hospital / Q000592:standards / Q000706:statistics & numerical data*; D006302:Health Services Research; D006743:Hospital Bed Capacity, under 100; D006780:Hospitals, Rural / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D017146:Models, Organizational; D015233:Models, Statistical; D010360:Patient Transfer; D019035:Rural Health Services / Q000592:standards / Q000600:supply & distribution; D012424:Rural Population / Q000706:statistics & numerical data; D013997:Time Factors; D017748:Time Management; D014739:Victoria / Q000453:epidemiology