Analysis of single-threshold ambulance diversion policies with simple destination rules

Ambulance Diversion (AD) has been the subject of numerous discussions and analyses recently. It has been criticized because of the significant impact from the potential delay in the transportation of an emergent patient. However, there is not sufficient evidence to suggest that AD is, in general, a poor choice to improve the performance of a regional emergency care delivery system. This paper shows a simulation-based analysis of single-threshold AD policies with simple patient destination rules in the context of a multi-hospital system. The objective is to determine the effect of a small set of combinations of AD policies and destination rules on the activities with non-value added time through Pareto analysis of the performance of multiple hospitals. The non-value added time is a metric that includes the transportation time, waiting time in the emergency department and boarding time. The findings of the analysis suggest that AD policies and an effective destination rule may reduce the delay that a patient spends to receive appropriate treatment at different stages of care.