California Ambulance Offload Times Exceed State Standards

TOPLINE:

Almost half of California’s local Emergency Medical Service (EMS) agencies report ambulance offload delays exceeding the 30-minute standard, according to a recent study.

METHODOLOGY:

• This cohort study analyzed 5,913,399 ambulance patient offload times (APOTs) across 34 California local EMS agencies using data from the California EMS Authority and local agencies between 2021 and 2023.
• Researchers collected county-level population data from the US Census Bureau to calculate the mean annual offloads per 1000 people.
• The key outcomes measured were total offload volumes, average annual offloads per 1000 people, variability in average APOTs, the range of median APOTs, and monthly, annual, and biannual reports for the entire study period.

TAKEAWAY:

• The APOT-1 weighted mean in California was 42.8 minutes, with a median monthly hospital-level APOT of 28.9 minutes, showing significant variation among local EMS agencies (P
• Sixteen agencies (47.1%) had an APOT-1 weighted mean exceeding the 30-minute state standard, and 13 agencies (38.2%) had a median APOT-1 over 30 minutes, reflecting persistent offload delays (P P
• Twenty agencies (60.6%) had worse APOT-1 weighted means in 2023 than in 2021, with Sacramento at 66.8 minutes and the North Coast region at 6.2 minutes, highlighting regional disparities in offload times (P

IN PRACTICE:

“Significant variation in the severity of ambulance offload delays between and within California local EMS agencies, with approximately one half of agencies consistently reporting offload times greater than the 30-minute state standard. The most severe delays are persistent in certain geographic regions, reflecting greater ED and hospital crowding,” the authors wrote.

SOURCE:

The study was led by Madeline Feldmeier, BS, University of California, San Francisco, and was published online on December 16, 2024, in JAMA Network Open.

LIMITATIONS:

The study was limited by gaps in data from the California EMS Authority, particularly for early 2023, and variations between hospital-level and agency-level reports. Additionally, missing data from major EMS agencies and the lack of data for the later months of 2023 may have influenced the findings.

DISCLOSURES:

The authors did not disclose any funding source or conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.