Is EMS Over or Under-Utilized in the South Bronx: A Restrospective View

In cities throughout the United States, access to health care is made possible largely through Emergency Medical Services. Unfortunately, the wide availability of services has led to claims of overuse and misuse of the transport system. Recently, the rising cost of healthcare has demanded a need to reduce waste.

Prior studies that investigated EMS usage patterns have used various criteria to assign “medical necessity”. We hypothesized that medically unnecessary non-urgent EMS transports were over utilized to St. Barnabas Hospital, Bronx, NY. Seven hundred and twenty patient encounters were examined through a retrospective chart review spanning one full calendar year from January 1 to December 31, 2002.

Our results reveal that 15% of the randomly selected patient encounters did not warrant emergent ambulance transport.  Although the outcome was less than our assumption and the figures reported in the review of the literature (The results have estimated that 31-92% of the ambulance transports to the hospitals were over utilized and determined “medically unnecessary” for emergent ambulance use),  1   2   3   4   5   6   7   adoption of alternate transport means could still result in significant savings.