Patient and Physician Perspectives on Ambulance Utilization

Author: Jacob Sharon   Jacoby Jeanne   Heller Michael   Stoltzfus Jill  

Publisher: Informa Healthcare

ISSN: 1090-3127

Source: Prehospital Emergency Care, Vol.12, Iss.2, 2008-04, pp. : 176-181

Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.

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Abstract

Objective. The objective of the current study was to define the clinical and demographic characteristics of ED patients who used ambulance transport (USERS) compared to contemporaneous non-ambulance users (NON) and to determine the reasons users gave for their choice to use ambulance transport. Methods. A single researcher queried a convenience sample of consenting ED patients regarding reasons for choice of transport to the ED, knowledge of ambulance cost, and self-estimation of illness or injury severity on a (1 most severe, 5 least severe) five-point Likert scale. We also asked if the treating physician agreed with transport choice. Results. Of 311 participants (97% response rate), USERS (N = 71, 22.8%) were older than NON (53 vs. 35, p < 0.0001) and were more sick according to self-rated illness severity (mean rank 128 vs. 156, p = 0.02), nurse triage score (mean rank 103 vs. 153, p < 0.0001), and admission rate (37% vs. 15%, p < 0.0001). Patient decision regarding ambulance use was associated with both having someone who called an ambulance for them and self-estimation of illness severity (or lack thereof). Physicians agreed with transport method in 68% of USERS and 92% of NON (overall kappa = 0.6, p < 0.0001). Conclusions. Ambulance users were more likely to be more sick as determined by commonly used measures than nonusers. ED physicians almost always agreed with nonuse of ambulance transport and two-thirds of the time agreed that a patient's decision to use ambulance transport was appropriate.

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