Luis M Pinet-Peralta1, Lukas J Glos2, Evan Sanna3, Brian Frankel3, Ernest Lindqvist3. 1. Maryland Institute for Emergency Medical Services Systems, University of Maryland School of Medicine, Baltimore, USA. lpinet-peralta@som.umaryland.edu. 2. The School of Public Policy, University of Maryland Baltimore County, Baltimore, USA. 3. Prince George's County Fire and EMS Department, Largo, USA.
Abstract
BACKGROUND: The provision of unnecessary Emergency Medical Services care remains a challenge throughout the US and contributes to Emergency Department overcrowding, delayed services and lower quality of care. New EMS models of care have shown promise in improving access to health services for patients who do not need urgent care. The goals of this study were (1) to identify factors associated with EMS utilization (911) and (2) their effects on total EMS calls and transports in an MIH program. METHODS: The study sample included 110 MIH patients referred to the program or considered high-users of EMS services between November 2016 and September 2018. The study employed descriptive statistics and Poisson regressions to estimate the effects of covariates on total EMS calls and transports. RESULTS: The typical enrollee is a 60-year-old single Black male living with two other individuals. He has a PCP, takes 12 medications and is compliant with his treatment. The likelihood of calling and/or being transported by EMS was higher for males, patients at high risk for falls, patients with asthma/COPD, psychiatric or behavioral illnesses, and longer travel times to a PCP. Each prescribed medication increased the risk for EMS calls or transports by 4%. The program achieved clear reductions in 911 calls and transports and savings of more than 140,000 USD in the first month. CONCLUSIONS: This study shows that age, marital status, high fall risk scores, the number of medications, psychiatric/behavioral illness, asthma/COPD, CHF, CVA/stroke and medication compliance may be good predictors of EMS use in an MIH setting. MIH programs can help control utilization of EMS care and reduce both EMS calls and transports.
BACKGROUND: The provision of unnecessary Emergency Medical Services care remains a challenge throughout the US and contributes to Emergency Department overcrowding, delayed services and lower quality of care. New EMS models of care have shown promise in improving access to health services for patients who do not need urgent care. The goals of this study were (1) to identify factors associated with EMS utilization (911) and (2) their effects on total EMS calls and transports in an MIH program. METHODS: The study sample included 110 MIHpatients referred to the program or considered high-users of EMS services between November 2016 and September 2018. The study employed descriptive statistics and Poisson regressions to estimate the effects of covariates on total EMS calls and transports. RESULTS: The typical enrollee is a 60-year-old single Black male living with two other individuals. He has a PCP, takes 12 medications and is compliant with his treatment. The likelihood of calling and/or being transported by EMS was higher for males, patients at high risk for falls, patients with asthma/COPD, psychiatric or behavioral illnesses, and longer travel times to a PCP. Each prescribed medication increased the risk for EMS calls or transports by 4%. The program achieved clear reductions in 911 calls and transports and savings of more than 140,000 USD in the first month. CONCLUSIONS: This study shows that age, marital status, high fall risk scores, the number of medications, psychiatric/behavioral illness, asthma/COPD, CHF, CVA/stroke and medication compliance may be good predictors of EMS use in an MIH setting. MIH programs can help control utilization of EMS care and reduce both EMS calls and transports.
Entities:
Keywords:
Community; Emergency; Emergency health; Health care; Mobile units; Population; Program specialist; Service
Authors: Karen Anna Abrashkin; Asantewaa Poku; Alyeah Ramjit; Jonathan Washko; Jenny Zhang; Michael Guttenberg; Kristofer Lawrence Smith Journal: BMJ Support Palliat Care Date: 2019-04-04 Impact factor: 3.568
Authors: Abbey Gregg; Joshua Tutek; Matthew D Leatherwood; William Crawford; Richard Friend; Martha Crowther; Robert McKinney Journal: Popul Health Manag Date: 2019-01-03 Impact factor: 2.459