Patient and physician perspectives on ambulance utilization

Area of Science:

• Emergency Medicine
• Health Services Research
• Transportation Medicine

Background:

• Ambulance use in emergency departments (EDs) presents a significant healthcare cost.
• Understanding patient characteristics and decision-making for ambulance transport is crucial for resource allocation and patient care.

Purpose of the Study:

• To define clinical and demographic characteristics of ED patients using ambulance transport versus non-users.
• To identify reasons cited by patients for choosing ambulance transport.
• To assess physician agreement with patient transport choices.

Main Methods:

• A convenience sample of ED patients (users and non-users of ambulance transport) were surveyed.
• Data collected included patient demographics, self-rated illness severity, knowledge of ambulance costs, and reasons for transport choice.
• Physician agreement with the chosen transport method was also recorded.

Main Results:

• Ambulance users (22.8%) were older and reported higher illness severity compared to non-users.
• Factors influencing ambulance use included having someone call for them and perceived illness severity.
• Physician agreement with transport method was 68% for users and 92% for non-users.

Conclusions:

• Ambulance users exhibit greater illness severity than non-users based on multiple measures.
• Physicians generally agreed with non-ambulance use and two-thirds of the time with patient-initiated ambulance use.
• Patient self-assessment of illness severity influences ambulance transport decisions.