Misuse of Emergency Ambulance Services

The general duty of an ambulance is to respond to the scene of an emergency, usually an injury or illness, and to transport the patient, or patients to the appropriate emergency department. Various studies have found however, that these emergency medical transport services are very often misused in response to non-emergency events.

Numerous studies undertaken regarding the misuse of ambulance services in different countries have shown extremely high rates of emergency service mistreatment. In England, Sweden, Canada and the United States it was found that at least 40 to 50 percent of ambulance usage was in response to non emergency events.

Research undertaken specifically in the United States, has revealed that the misuse of ambulance services is directly correlated with factors such as income status and level of education. In some areas inappropriate ambulance utilization has therefore been closely linked with Medicaid members, who are evidently low income earners. One study in particular found that 83.5 percent of patients who were Medicaid members were brought to the emergency department in an ambulance for a non-urgent ailment.

Reasons for Misuse of Ambulance Services

There are numerous differing opinions as to why ambulance misuse occurs, the most obvious reasons regarding Medicaid patients are believed to be:

  • Restricted access to transportation
  • Restricted access to medical care (a consequence of no access to transportation)
  • Restricted knowledge regarding ambulance services

In some rural and suburban areas it has been found that over 50 percent of the population has no access to public transport. For a low income earner with no access to private transport, this means that regular doctors’ visits are almost impossible; hence the use of emergency services when healthcare is needed.

It is easy however to solely blame patients for the inappropriate use of these services. For this misuse to occur a dispatcher must assess the patients’ situation and decide whether or not to deploy the ambulance. The ambulance personnel must further assess the patient decide whether or not to bring them to the emergency department.

Possible Steps to Mitigate Misuse of Medical Transport Services

The problem regarding the inappropriate use of ambulances services by Medicaid patients is nothing new. There have been masses of papers written regarding this theme, and there are various projects already in effect to attempt to curve the negative effect that this ambulance misuse has on emergency services departments across the United States.

One of the most successful of these projects is the Non-Emergency Medical Transport program (NEMT), which is run through Medicaid. This arrangement basically involves the provision of various non-emergency forms medical transportation to patients that have no other options. Over 400,000 people currently use this service every year.
There are however some issues with the program, such as the high demand for transport being unable to be met, and after hours transport being problematic. Transport must also be booked in advance which doesn’t allow for spontaneous doctors visits due to sudden onset ailments.

The issues regarding dispatcher and ambulance misjudgment of patient severity are problems that would need to be individually addressed within the various types of medical transportation services. As emergency transport resources are spread ever thinner however, this is something that ambulance services need to start looking into and taking more seriously.