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Bridging the emergency medical services for children information gap
T C Murdock1, J F Knapp, M D Dowd
1Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO, USA.
Insights
Pediatric emergency medical services (EMS) usage is higher among infants, uninsured, Medicaid-insured, and low-income children in urban areas. Further research is needed to understand the reasons for this disparity.
Area of Science:
- Pediatric Emergency Medicine
- Public Health
- Epidemiology
Background:
- Prehospital emergency medical services (EMS) are crucial for pediatric care.
- Understanding the epidemiology of pediatric EMS utilization is vital for resource allocation and public health initiatives.
Purpose of the Study:
- To determine the epidemiological features of pediatric prehospital emergency medical services (EMS) usage in a defined urban population.
Main Methods:
- Analysis of pediatric EMS transports (under 15 years) in Kansas City, MO, from 1993-1995.
- Calculation of annual transport rates per 1,000 persons using census data.
- Examination of demographic, insurance, and socioeconomic factors associated with EMS use.
Main Results:
- A total of 7,296 pediatric transports occurred, with an annual rate of 21.9 per 1,000 children.
- Infants (<1 year) had the highest EMS usage rate (47.4 per 1,000).
- Children from low-income areas were 5.8 times more likely to use EMS; half were insured by Medicaid or uninsured.
Conclusions:
- Pediatric EMS users in Kansas City were disproportionately infants, Medicaid-insured or uninsured, and from low-income neighborhoods.
- Further investigation is required to ascertain if increased usage stems from greater illness/injury incidence, socioeconomic barriers, or other factors.
Objective:
To determine the epidemiological features of pediatric usage of prehospital emergency medical services (EMS) in a defined urban population.
Methods:
Residents of Kansas City, Mo, younger than 15 years who used EMS during the calendar years 1993-1995 were included. In this geographic area there is a single provider of prehospital care; all numerator data were taken from this single source. Denominator data were provided by 1995 intercensal estimates based on the 1990 US Census. Rates were calculated as an annual average and reported as the number of children transported per 1 000 persons per year.
Results:
There were a total of 7296 pediatric EMS transports during the study period, for an annual rate of 21.9. Infants younger than 1 year had the highest rate (47.4), followed by those aged 1 to 4 years (26.2), 10 to 14 years (17.5), and 5 to 9 years (17.3). Medicaid was the insurer for half and 27% were uninsured. One quarter of the patients used EMS more than once. Children living in ZIP codes in the lowest median income tertile were 5.8 times more likely to use EMS than those in the upper income tertile (95% confidence interval, 5.4-6.3). One third of all transports occurred between the hours of 4 and 8 PM.
Conclusions:
Children using the Kansas City EMS were more likely to be infants, insured by Medicaid or uninsured, and live in low-income ZIP codes. Further study is needed to determine if this increased usage is due to greater incidence and severity of illness and injury, lack of transportation, lack of education, or other factors.