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Medically Unnecessary Emergency Medical Services (EMS) Transports Among Children Ages 0 to 17 Years

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Abstract

Objectives: Estimate the prevalence of medically unnecessary Emergency Medical Services (EMS) transports among children. Methods: We linked EMS and emergency department (ED) billing records for all EMS-to-hospital transports of children originating in three counties in South Carolina between January 1, 2001 and March 31, 2003. EMS responses resulting in no transport, transports to destinations other than the ED, or multiple trips for the same child in a single day could not be linked to ED data and were excluded. Medically unnecessary transports were identified with an algorithm using pre-hospital impressions, ED diagnoses and ED procedures. After exclusions, 5,693 transports of children between 0 and 17 years were available for study. Results: Sixteen percent (16.4%) of all transports were medically unnecessary. Among children through age 12, upper respiratory and viral problems were the most common diagnoses associated with medically unnecessary transports; among older children, behavioral problems such as conduct disturbance or drug abuse were common. In multivariable analysis, the odds of an unnecessary transport were higher among younger children, non-white children, rural children, and children insured by Medicaid. Conclusions: The proportion of EMS transports which may be medically unnecessary is relatively modest compared to previous studies. However, many questions remain for future research. Further investigation should include examination of primary care availability and occurrence of unnecessary EMS use, existence of race-based disparities, and transports involving conduct disturbance and other behavioral conditions among children.

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Acknowledgements

This research was supported in part by a National Research Service Award Post-Doctoral Traineeship from the Agency for Healthcare Research and Quality sponsored by the Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Grant No. T32-HS000032.

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Authors and Affiliations

  1. Cecil G Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, 725 Martin Luther King Jr., Blvd., CB# 7590, Chapel Hill, NC, 27599, USA

    P. Daniel Patterson & Charity G. Moore

  2. Department of Family and Preventive Medicine, University of South Carolina School of Medicine, 3209 Colonial Drive, Columbia, SC, 29203, USA

    Elizabeth G. Baxley

  3. Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, 800 Sumter Street, Columbia, SC, 29208, USA

    Janice C. Probst

  4. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 800 Sumter Street, Columbia, SC, 29208, USA

    James R. Hussey

  5. Departments of Medicine & Biostatistics, Division of General Medicine and Epidemiology, University of North Carolina at Chapel Hill, 1163C Bioinformatics Bldg, CB# 7110, Chapel Hill, NC, 27599, USA

    Charity G. Moore

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  1. P. Daniel Patterson
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Correspondence to P. Daniel Patterson.

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Patterson, P.D., Baxley, E.G., Probst, J.C. et al. Medically Unnecessary Emergency Medical Services (EMS) Transports Among Children Ages 0 to 17 Years. Matern Child Health J 10, 527–536 (2006). https://doi.org/10.1007/s10995-006-0127-6

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  • DOI: https://doi.org/10.1007/s10995-006-0127-6

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