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Utilization of emergency medical services in a large urban area: description of call types and temporal trends.
Prehosp Emerg Care. 2011 Jul-Sep; 15(3):371-80.PE

Abstract

BACKGROUND

Emergency medical services (EMS) systems are used by the public for a range of medically related problems.

OBJECTIVE

To understand and analyze the patterns of EMS utilization and trends over time in a large urban EMS system so that we may better direct efforts toward improving those services.

METHODS

The 63 call type designations from all New York City (NYC) 9-1-1 EMS calls between 1999 and 2007 were obtained and grouped into 10 broad and 30 specific medical categories. Aggregated numbers of total EMS calls and individual categories were divided by NYC resident population estimates to determine utilization rates. Temporal trends were evaluated for statistical significance with Spearman's rho (ρ).

RESULTS

There were 9,916,904 EMS calls between 1999 and 2007, with an average of 1,101,878 calls/year. Utilization rates increased from 129.5 to 141.9 calls/1,000 residents/year over the study period (average annual rise of 1.16%). Among all medical/surgical call types (excluding trauma), there was an average annual increase of 1.8%/year. The most substantial increases were among "psychiatric/drug related" (+5.6%/year), "generalized illness" (+3.2%/year), and "environmental related" calls (+2.9%/year). The largest decrease was among "respiratory" calls (-1.2%/year), specifically for "asthma" (-5.0%/year). For trauma call types, there was an annual average decrease of 0.4%/year, with the category of "violence related" calls having the greatest decline (-3.3%/year).

CONCLUSION

There was an increase in overall EMS utilization rates, though not all call types rose uniformly. Rather, a number of significant trends were identified reflecting either changing medical needs or changing patterns of EMS utilization in NYC's population.

Authors+Show Affiliations

Office of Medical Affairs, The New York City Fire Department, Brooklyn, New York 11201, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21521036

Citation

Munjal, Kevin G., et al. "Utilization of Emergency Medical Services in a Large Urban Area: Description of Call Types and Temporal Trends." Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors, vol. 15, no. 3, 2011, pp. 371-80.
Munjal KG, Silverman RA, Freese J, et al. Utilization of emergency medical services in a large urban area: description of call types and temporal trends. Prehosp Emerg Care. 2011;15(3):371-80.
Munjal, K. G., Silverman, R. A., Freese, J., Braun, J. D., Kaufman, B. J., Isaacs, D., Werner, A., Webber, M., Hall, C. B., & Prezant, D. J. (2011). Utilization of emergency medical services in a large urban area: description of call types and temporal trends. Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors, 15(3), 371-80. https://doi.org/10.3109/10903127.2011.561403
Munjal KG, et al. Utilization of Emergency Medical Services in a Large Urban Area: Description of Call Types and Temporal Trends. Prehosp Emerg Care. 2011 Jul-Sep;15(3):371-80. PubMed PMID: 21521036.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Utilization of emergency medical services in a large urban area: description of call types and temporal trends. AU - Munjal,Kevin G, AU - Silverman,Robert A, AU - Freese,John, AU - Braun,James D, AU - Kaufman,Bradley J, AU - Isaacs,Douglas, AU - Werner,Andrew, AU - Webber,Mayris, AU - Hall,Charles B, AU - Prezant,David J, Y1 - 2011/04/26/ PY - 2011/4/28/entrez PY - 2011/4/28/pubmed PY - 2011/9/29/medline SP - 371 EP - 80 JF - Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors JO - Prehosp Emerg Care VL - 15 IS - 3 N2 - BACKGROUND: Emergency medical services (EMS) systems are used by the public for a range of medically related problems. OBJECTIVE: To understand and analyze the patterns of EMS utilization and trends over time in a large urban EMS system so that we may better direct efforts toward improving those services. METHODS: The 63 call type designations from all New York City (NYC) 9-1-1 EMS calls between 1999 and 2007 were obtained and grouped into 10 broad and 30 specific medical categories. Aggregated numbers of total EMS calls and individual categories were divided by NYC resident population estimates to determine utilization rates. Temporal trends were evaluated for statistical significance with Spearman's rho (ρ). RESULTS: There were 9,916,904 EMS calls between 1999 and 2007, with an average of 1,101,878 calls/year. Utilization rates increased from 129.5 to 141.9 calls/1,000 residents/year over the study period (average annual rise of 1.16%). Among all medical/surgical call types (excluding trauma), there was an average annual increase of 1.8%/year. The most substantial increases were among "psychiatric/drug related" (+5.6%/year), "generalized illness" (+3.2%/year), and "environmental related" calls (+2.9%/year). The largest decrease was among "respiratory" calls (-1.2%/year), specifically for "asthma" (-5.0%/year). For trauma call types, there was an annual average decrease of 0.4%/year, with the category of "violence related" calls having the greatest decline (-3.3%/year). CONCLUSION: There was an increase in overall EMS utilization rates, though not all call types rose uniformly. Rather, a number of significant trends were identified reflecting either changing medical needs or changing patterns of EMS utilization in NYC's population. SN - 1545-0066 UR - https://www.unboundmedicine.com/medline/citation/21521036/Utilization_of_emergency_medical_services_in_a_large_urban_area:_description_of_call_types_and_temporal_trends_ L2 - https://www.tandfonline.com/doi/full/10.3109/10903127.2011.561403 DB - PRIME DP - Unbound Medicine ER -