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EMS utilization predictors in a Mobile Integrated Health (MIH) program.

Luis M Pinet-Peralta1, Lukas J Glos2, Evan Sanna3

  • 1Maryland Institute for Emergency Medical Services Systems, University of Maryland School of Medicine, Baltimore, USA. lpinet-peralta@som.umaryland.edu.

BMC Medical Informatics and Decision Making
|February 5, 2021
PubMed
Summary

Unnecessary Emergency Medical Services (EMS) use is reduced by Mobile Integrated Healthcare (MIH) programs. Factors like age, fall risk, and multiple medications predict EMS utilization, but MIH interventions lower calls and transports.

Keywords:
CommunityEmergencyEmergency healthHealth careMobile unitsPopulationProgram specialistService

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Area of Science:

  • Healthcare Management
  • Public Health
  • Emergency Medicine

Background:

  • Unnecessary Emergency Medical Services (EMS) utilization contributes to Emergency Department (ED) overcrowding and impacts care quality.
  • New EMS care models, such as Mobile Integrated Healthcare (MIH), show potential for improving access for non-urgent cases.
  • Identifying factors driving EMS utilization is crucial for optimizing healthcare resource allocation.

Purpose of the Study:

  • To identify factors associated with EMS utilization (911 calls) among patients in an MIH program.
  • To assess the impact of these factors on total EMS calls and transports within the MIH program.

Main Methods:

  • A study sample of 110 MIH patients, including high-users of EMS services, was analyzed.
  • Descriptive statistics and Poisson regressions were used to evaluate the effects of various covariates on EMS calls and transports.

Main Results:

  • The typical MIH enrollee was a 60-year-old single Black male with multiple medications and a high-risk profile for EMS use.
  • Higher likelihood of EMS calls/transports was observed in males, high fall risk patients, those with asthma/COPD, psychiatric/behavioral illnesses, and longer travel times to a Primary Care Provider (PCP).
  • Each additional medication increased the risk for EMS calls or transports by 4%; the MIH program achieved significant reductions in calls and transports, with over $140,000 USD in savings in the first month.

Conclusions:

  • Predictors of EMS use in MIH settings include age, marital status, fall risk, medication count, psychiatric/behavioral illness, asthma/COPD, Congestive Heart Failure (CHF), Cerebrovascular Accident (CVA)/stroke, and medication compliance.
  • MIH programs are effective in managing EMS utilization, leading to reduced EMS calls and transports.
  • Implementing MIH programs can optimize healthcare delivery and reduce healthcare costs associated with unnecessary EMS use.