ArticleJAMA network open2024
Patterns in California Ambulance Patient Offload Times by Local Emergency Medical Services Agency.
Article in JAMA network open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- When ambulances wait at the emergency department: hospital factors and offload times in California.Health affairs scholar · 2026Article
- Waiting time ambulances in the Emergency Department; a Dutch single center study (WAITED study).International journal of emergency medicine · 2025Article
- Racial and Socioeconomic Disparities in California Ambulance Patient Offload Times.JAMA network open · 2025Article
- Error in Results and Discussion.JAMA network open · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Ambulance offload delays are a timely and crucial issue with implications for patients, emergency medical services (EMS) agencies, hospitals, and communities. Published data on recent patterns in ambulance patient offload times (APOTs) are sparse. Objective: To examine patterns in APOT by California local EMS agency and variation between and within local agencies. Design, Setting, and Participants: This cohort study used APOT reports from the California EMS Authority and local EMS agencies between January 1, 2021, and June 30, 2023, to examine patterns in ambulance offload times. County-level population data were collected from the US Census Bureau to calculate mean annual offloads per 1000 population. Exposure: Ambulance transport to emergency departments. Main Outcomes and Measures: Ambulance offload volumes, mean annual offloads per 1000 population, APOT-1 (a reporting metric that includes the 90th percentile ambulance offload time and number of offloads to a specific hospital) weighted means (SDs), and APOT-1 medians (IQRs). Results: A total of 5 913 399 offloads across 34 California local EMS agencies were analyzed. The APOT-1 weighted mean (SD) across the state was 42.8 (27.3) minutes, and the median (IQR) monthly hospital-level APOT-1 was 28.9 (14.9-46.3) minutes. Nearly one-half of local EMS agencies (16 of 34 [47.1%], accounting for 79.2% of all offloads) experienced an APOT-1 weighted mean greater than the 30-minute standard set by the state. Moreover, 20 of 33 local EMS agencies (60.6%) reported an annual APOT-1 weighted mean that was worse in 2023 than 2021. Conclusions and Relevance: In this cohort study, approximately half of all agencies consistently reported ambulance offload times greater than the 30-minute state standard, and there was significant variation between and within agencies. These findings may spur collaborative efforts between stakeholders to determine the most effective strategies for addressing systemic issues resulting in long APOT across California.
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