Non-Emergency Transportation Services: Saving the Modern Ambulance Service?

Over the last decade ambulance services in many first world countries such as the United States and Australia have come increasingly under fire. Some of the criticisms put forward by various experts and authors have been: the less than acceptable response time of emergency vehicles; the improper standard of care provided by ambulances, with paramedics accused of ‘scooping and running’; the lower than ideal safety of ambulance operations; and the misuse of ambulance services for non-emergency transportation services.

One of the things that many critics have overlooked, however, is the amount of pressure that ambulance programs in many regions are operating under. Emergency vehicles in most communities are expected to carry out a number of different roles, including acting as: first responder vehicles; non-emergency patient transfer vehicles; and general non-emergency transportation measures. This is especially problematic in many rural and remote areas owing to the overall shortage of general transportation options.

The Role of Non-Emergency Transportation Services in Assisting Emergency Services

It is obvious that ambulance services in most of these regions are unable to satisfactorily fulfill their various enforced rolls. This has caused a marked drop in the standard of care, with some areas throughout the United States in particular, referring to the current state of the healthcare system as a ‘healthcare crisis’. In order to change the current condition of these services, governmental organizations have begun looking into non-emergency medical transportation.

The idea behind the introduction or furtherance of non-emergency transportation services is that providing alternative means of transportation frees-up emergency ambulance service resources, as well as allowing patients better access to primary medical care. The issue in many countries however, is the extent to which these non- emergency transportation programs are implemented.

In the United States a comprehensive non-emergency transportation services program is said to be in operation. This service involves state and private transportation companies, transportation brokers and the government subsidization of non-emergency medical transport. The program is however, operated by Medicaid, and as such, is only available to Medicaid members, which include low income individuals or families, and individuals with certain disabilities.

This is problematic, as the program excludes a significant majority of the over 65 population, who are generally Medicare, not Medicaid members. Medicare members are only entitled to non-emergency care in particular cases, and if they choose to utilize non-emergency transport and Medicare deems it unnecessary, the patient is required to pay the full transport costs. Many elderly people consequently don’t utilize any form of medical transportation until the situation becomes critical and requires emergency transportation.

The fact that the elderly population in countries such as America account for at least a third of emergency transportation cases, makes this situation even direr, as those that utilize the majority of the resources are not being correctly included in the non-emergency programs.

It is therefore proposed that although non-emergency transportation systems are being implemented in many regions, and are somewhat successful in reducing ambulance misuse, certain aspects of many of these programs need to be altered. In order to reduce the pressure currently placed on emergency services, programs need to be geared toward those that demand the majority of emergency resources, which in most areas are geriatrics.