title: The financial impact of ambulance diversions and patient elopements.
abstract: OBJECTIVE
  Admission process delays and other throughput inefficiencies are a leading cause of emergency department (ED) overcrowding, ambulance diversion, and patient elopements. Hospital capacity constraints reduce the number of treatment beds available to provide revenue-generating patient services. The objective of this study was to develop a practical method for quantifying the revenues that are potentially lost as a result of patient elopements and ambulance diversion.
  
  
  METHODS
  Historical data from 62,588 patient visits to the ED of a 450-bed nonprofit community teaching hospital in central Pennsylvania between July 2004 and June 2005 were used to estimate the value of potential patient visits foregone as a result of ambulance diversion and patients leaving the ED without treatment.
  
  
  RESULTS
  The study hospital may have lost 3,881,506 dollars in net revenue as a result of ambulance diversions and patient elopements from the ED during a 12-month period.
  
  
  CONCLUSIONS
  Significant revenue may be foregone as a result of throughput delays that prevent the ED from utilizing its existing bed capacity for additional patient visits.
authors.affiliation: Health Services Design Section, Department of Emergency Medicine, York Hospital, WellSpan Health System, York, PA, USA. tfalvo@wellspan.org
authors.forename: Thomas
authors.initials: T
authors.lastname: Falvo
authors.forename: Lance
authors.initials: L
authors.lastname: Grove
authors.forename: Ruth
authors.initials: R
authors.lastname: Stachura
authors.forename: William
authors.initials: W
authors.lastname: Zirkin
mesh_terms: D000552:Ambulances / Q000191:economics / Q000458:organization & administration*; D001509:Bed Occupancy; D003441:Crowding; D017598:Efficiency, Organizational; D004632:Emergency Medical Services / Q000191:economics; D004636:Emergency Service, Hospital / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D006745:Hospital Bed Capacity, 300 to 499; D017721:Hospital Costs; D006764:Hospitals, Community / Q000191:economics*; D006801:Humans; D010352:Patient Dropouts; D010360:Patient Transfer / Q000191:economics; D010414:Pennsylvania; D012189:Retrospective Studies