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Updated: Jul 13, 2026
16:14
Trajectory Data Analyses for Pedestrian Space-time Activity Study
Published on: February 25, 2013
Path analysis modeling indicates free transport increases ambulance use for minor indications
Joseph Yuk Sang Ting1, Allan M Z Chang
1Department of Emergency Medicine, Mater Public Adult Hospital, South Brisbane, Australia. jysting@uq.edu.au
Prehospital Emergency Care
|September 26, 2006
Summary
Abolishing ambulance transport fees in 2003 led to increased ambulance use, particularly among younger patients with less severe conditions. This suggests that removing direct patient costs may encourage inappropriate ambulance utilization.
Area of Science:
- Emergency medicine
- Health services research
Background:
- Clinically unnecessary ambulance transport strains limited resources.
- Anecdotal evidence suggested increased inappropriate ambulance use after direct patient costs were abolished.
Purpose of the Study:
- To assess the influence of age, illness acuity, and admission necessity on ambulance use following the abolition of direct patient fees.
- To compare ambulance utilization patterns before and after the policy change.
Main Methods:
- Analysis of 55,397 emergency department attendances in 2002 and 2004.
- Comparison of ambulance users versus nonusers using chi-square tests.
- Logistic regression and path analysis to model factors influencing ambulance use.
Main Results:
- Ambulance use increased by 14% in 2004 compared to 2002 (OR 1.14).
- Users in 2004 were younger, had lower illness acuity, and less need for admission compared to 2002.
- A negative correlation was observed between ambulance use in 2004 and illness acuity.
Conclusions:
- Abolishing direct patient costs for ambulance transport is associated with increased ambulance utilization.
- The increase in use was linked to patients with lower illness acuity and reduced need for admission.
- Policy changes regarding patient cost-sharing significantly impact ambulance service demand and resource allocation.
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