A mobile intensive care ambulance--use by community primary care teams

This study investigates the use of a mobile intensive care ambulance (MICA) by primary care teams in a large, semi-rural health district in northern Israel.

We reviewed the MICA records covering three years for all calls from a doctor or a nurse working in a community primary care clinic.

Over the period studied, there were 649 such calls. Two-thirds of the patients were male, 70.5% were aged 60+ and only 2% were children under the age of one year. Of the total, 358 (55.2%) calls originated from kibbutzim (communal settlements), although only 7.5% of the district's population lives on such settlements. There were 12 calls (1.9%) from Arab villages, where 27.5% of the district population resides. The MICA personnel were more intervention prone than was the primary care team. The service was utilized mainly for cardiovascular emergencies and, in this study, children and residents of Arab villages appear to have been underserved. There was a disproportionately high representation of elderly kibbutz members.

There is a need for further research to assess standards for emergency equipment in primary care clinics, and continuous training of the primary care team. Introduction of a high service technology such as the MICA might be a problem in certain populations.