79 What is the economic impact of different types of ems response?. (16th April 2018)

• Record Type: Journal Article
• Authors: Turner, J; Bell-Gorrod, H; Dixon, S
• Is Part Of: BMJ open. Volume 8:Supplement 1(2018)
• Page Start: A30
• Page End: A30
• Publication Date: 2018-04-16
• Subjects: Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2018-EMS.79
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Aim: Modern EMS provides a range of response options including management by: telephone, management and discharge or referral at scene or transport to hospital. We used linked data of ambulance records, hospital records and national mortality statistics for all calls to one ambulance service in England in a 6 month period to assess the costs associated with each response option. Method: We calculated costs for each type of EMS response using the linked data and NHS Reference Costs. We then used two risk adjusted indicators measuring: rates of telephone or at scene management attending ED or admitted to hospital within 3 days and rates of patients taken to hospital and discharged from ED without treatment to identify matched cases of correct and incorrect response decisions to compare costs of each decision type. Results: 1 82 566 cases were included with 5.6% managed by telephone (mean cost £125), 28% discharged at scene (mean cost £415) and 66.4% transported to hospital (mean cost £1745). Mean cost of an incorrect transport decision was an additional £313 and an incorrect non-transport decision £237 per case. Conclusion: The main reason for differences in response types is inpatient costs for admitted patients. Improvement in decision making about whether or not to take people to hospital could potentially result in substantial savings in urgent care system costs. Conflict of interest: None Funding: NIHR Programme Grants for Applied Research.