Premium
Impact of Ambulance Transportation on Resource Use in the Emergency Department
Author(s) -
Marinovich Adrian,
Afilalo Jonathan,
Afilalo Marc,
Colacone Antoinette,
Unger Bernard,
Giguère Claudine,
Léger Ruth,
Xue Xiaoqing,
Boivin JeanFran c¸ois,
MacNamara Elizabeth
Publication year - 2004
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.2004.tb02218.x
Subject(s) - medicine , emergency department , medical emergency , resource use , resource (disambiguation) , emergency medical services , emergency medicine , nursing , environmental resource management , computer network , environmental science , computer science
Objective: To determine how ambulance transportation is associated with resource use in the emergency department (ED). Methods A retrospective administrative database review of patient visits to a Montreal tertiary care hospital ED in one year (April 2000–March 2001). Measures of resource use included ED length of stay, admission to the hospital, and whether consultations and radiology/imaging tests (excluding plain‐film x‐rays) were ordered from the ED. Results During the study period, 39,674 patients made 59,142 visits to the ED. Ambulance transportation was used for 15.6% of these ED visits. Compared with non‐ambulance visits, ambulance visits were more likely to be made by older patients (mean age: 68 vs. 47 years), to be made by females (59% vs. 55%), to have a greater triage urgency score (mean on 1–5 scale, with 1 most urgent: 2.7 vs. 3.9), and to occur after office hours, 5 pm to 9 am (47% vs. 43%). Ambulance visits were also more likely than non‐ambulance visits to result in: a longer length of stay (mean: 13.3 hours [95% CI = 13.0 to 13.6] vs. 5.9 [95% CI = 5.8 to 6.0]), hospital admission (40% vs. 10%) (odds ratio [OR]: 5.94 [95% CI = 5.59 to 6.33]), consultations (56% vs. 20%) (OR: 5.15 [95%= 4.86 to 5.45]), and radiology/imaging tests (20% vs. 12%) (OR: 1.93 [95% CI = 1.81 to 2.07]). In multivariate models that adjusted for the effects of age, gender, triage urgency, and temporal factors, ambulance transportation maintained its association with greater resource use. Conclusions: This preliminary study indicates that patients arriving at the ED by ambulance use significantly more resources than their walk‐in counterparts.