Wednesday, October 25, 2017

Study looks at states' ambulance use to guide policy; many areas run short of paramedics, EMTs

Kentucky, Alabama, South Carolina, Tennessee and West Virginia were the top five states in the use of ambulances in 2012-14, with Alaska, Arizona, Colorado, Hawaii, Nevada and Utah at the bottom of the list, according to a study aimed at helping policymakers make better decisions about their ambulance services, which provide a vital service to communities.

The study, conducted by the Rural and Underserved Health Research Center at the University of Kentucky, looked at Medicare beneficiaries using both ground and air ambulance services, the number of miles they were transported per year and per day, and the number of days of services they used in a year. The researchers said they used Medicare data because the benefits are the same nationwide, making it easier to make regional comparisons.

Parsing data by regional census divisions, the study found found that 13 percent of Medicare beneficiaries in the East South Central division (Kentucky, Alabama, Mississippi and Tennessee) used a ground ambulance service and traveled almost 33 miles per year, on average -- the most of any division. The typical usage in the region was two days a year, with an average trip of 16 miles.

The study found that in 2014, Medicare beneficiaries in New England had the highest ground-ambulance usage and the Mountain division had the lowest. It found those in the Southeast (East South Central and South Atlantic) traveled further per year and per day, and received transportation more often than other areas of the U.S. The West North Central states (Kansas, Missouri, Iowa, Nebraska, Minnesota and the Dakotas) were transported more miles per day per beneficiary, but also traveled fewer days per year. Air transportation was most prevalent in the West (comprising the Mountain and Pacific divisions), but the report points out that the number of people using air ambulance service was small compared to ground transportation.

"From our study, we believe policymakers and researchers need to consider differences across the regions of the U.S. when evaluating reimbursement and rules about usage," the researchers wriote. "When looking at changes in the supply of ambulance services in an area, we need to consider the current rate of usage of those services. An area which relies more heavily on these services would react differently to a change in policy than an area with lesser usage."

The report says many ambulance services are at risk of scaling back or closing their doors because of finances. Mike Poynter, the executive director of the Kentucky Board of Emergency Medical Services, told Kentucky Health News that one of the profession's greatest challenges is that policymakers and the public don't really know "what we do or how we do it." He noted that the training to become a paramedic lasts at least 18 months, and many paramedics have advanced degrees in emergency care. "We've got to do better in educating the decision makers on what we actually do and how vital our role is in the community." For the KHN report on the study, click here.

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