ArticleAnnals of emergency medicine2017
Geographic Variation in Use of Ambulance Transport to the Emergency Department.
Article in Annals of emergency medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed.
- Disparities in direct access to acute geriatric care - an observational analysis of geographic variations of ambulance conveyance.BMC geriatrics · 2026Observational
- Increase in 9-1-1 activations for obstetric-related emergencies following the Dobbs decision in the United States.American journal of epidemiology · 2025Article
- Ambulance Use Appropriateness: Emergency Medical Service Technicians' and Triage Nurses' Assessments and Patients' Perceptions.Nursing reports (Pavia, Italy) · 2025Article
- Assessing Patient Satisfaction with Hospital Services: Perspectives from Bihor County Emergency Hospital, Romania.Healthcare (Basel, Switzerland) · 2025Article
- Article
- Emergency Medical Services Provider-Perceived Alzheimer's Disease and Related Dementias in the Prehospital Setting.The western journal of emergency medicine · 2025Article
- Article
- The Use of Medical Services for Low-Acuity Emergency Cases in Germany: Protocol for a Multicenter Observational Pilot Study.JMIR research protocols · 2024Article
- Emergency medical services utilisation among febrile children attending emergency departments across Europe: an observational multicentre study.European journal of pediatrics · 2023Observational
- Article
- Ambulance use and subsequent fragmented hospital readmission among older adults.Journal of the American Geriatrics Society · 2023Article
- Association of distance between hospitals and volume of shared admissions.BMC health services research · 2022Article
- EMS non-conveyance: A safe practice to decrease ED crowding or a threat to patient safety?BMC emergency medicine · 2021Article
- Investigating the Geographic Disparities of Amenable Mortality and Related Ambulance Services in Hungary.International journal of environmental research and public health · 2021Article
- Article
- Emergency Medical Service Use Among Latinos Aged 50 and Older in California Counties, Except Los Angeles, During the Early COVID-19 Pandemic Period.Frontiers in public health · 2021Article
- Disparities between Rural and Urban Areas of the Central Region of Saudi Arabia in the Utilization and Time-Centeredness of Emergency Medical Services.International journal of environmental research and public health · 2020Article
- Disparities in Emergency Department Visits Among Collocated Racial/Ethnic Medicare Enrollees.Annals of emergency medicine · 2019Article
- Emergency Medical Services Utilization for Acute Stroke Care: Analysis of the Paul Coverdell National Acute Stroke Program, 2014-2019.Prehospital emergency careArticle
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
STUDY
objectiveEvidence on variability in emergency medical services use is limited. We obtain national evidence on geographic variation in the use of ambulance transport to the emergency department (ED) among Medicare enrollees and assess the role of health status, socioeconomic status, and provider availability.
methodsWe used 2010 Medicare claims data for a random sample of 999,999 enrollees aged 66 years and older, and identified ambulance transport and ED use. The main outcome measures were number of ambulance transports to the ED per 100 person-years (ambulance transport rate) and proportion (percentage) of ED visits by ambulance transport by hospital referral regions.
resultsThe national ambulance transport rate was 22.2 and the overall proportion of ED visits by ambulance was 36.7%. Relative to hospital referral regions in the lowest rate quartile, those in the highest quartile had a 75% higher ambulance transport rate (incidence rate ratio [IRR] 1.75; 95% confidence interval [CI] 1.69 to 1.81) and a 15.5% higher proportion of ED visits by ambulance (IRR 1.155; 95% CI 1.146 to 1.164). Adjusting for health status, socioeconomic status, and provider availability reduced quartile 1 versus quartile 4 difference in ambulance transport rate by 43% (IRR 1.43; 95% CI 1.38 to 1.48) and proportion of ED visits by ambulance by 7% (IRR 1.145; 95% CI 1.135 to 1.155). Among the 3 covariate domains, health status was associated with the largest variability in ambulance transport rate (30.1%), followed by socioeconomic status (12.8%) and provider availability (2.9%).
conclusionGeographic variability in ambulance use is large and associated with variation in patient health status and socioeconomic status.
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