Paramedic PapersHome Operations & systems Who calls an ambulance for low-acuity problems
Operations & systems
Who calls an ambulance for low-acuity problems
Factors Associated with Low-Acuity EMS Transport to the Emergency Department: An Observational Study Guided by the Andersen Behavioral Model
Prehospital Emergency Care · 2026-10-12 · Added 13 October 2026
Retrospective study of 41,761 low-acuity ED visits in the southeastern US found only 7.7% arrived by ambulance, with the highest odds among retired or disabled (aOR 3.60) and unemployed (aOR 2.26) patients and the lowest among those with an established GP (aOR 0.57).
- Study type
- Cohort
- Design
- Retrospective multicentre observational cohort (secondary EHR analysis)
- Participants
- 41,761 low-acuity ED encounters across 21 EDs
- Main finding
- 3,232 of 41,761 discharged low-acuity patients (7.7%) arrived by EMS; nighttime presentation (aOR 1.63) and mental health diagnosis (aOR 1.76) also raised the odds
- Caveat
- Captured only visits ending in ED discharge in one US region, so admitted low-acuity transports and the fully transported caseload aren't represented
- Bottom line
- Context only
Why it matters in Australia (Medium relevance). Low-acuity demand and alternative referral pathways are live issues for Australian ambulance services, though the US insurance-driven ED setting limits direct comparison.
Learning goal
Understand the access and social factors that lead Australian patients to call an ambulance for low-acuity problems.
More
- Topic: Operations & systems
- Daily scan: 13 October 2026
- Podcast: Paramedic Papers Daily, 13 October 2026
Related papers on Operations & systems
-
Mass-gathering EMS and hospital surge planning
Structured narrative review of EMS and hospital surge integration for mass gatherings found median presentation rates around 6.2 per 1,000 attendees and transport rates of 0.35 per 1,000, but hospital effects too heterogeneous for firm conclusions.
-
Community paramedic referrals cut ambulance use
Chicago fire-department community paramedics running a 4-visit referral program from primary care medical homes across hypertension, diabetes, asthma/COPD and heart failure pathways — 68 graduates saw 911 ambulance transports down 43%, ED visits down 46% and admissions down 42% at six months.
-
Lactate drives prehospital mSOFA risk
Prospective Spanish multicentre study of 12,212 high-priority patients deconstructed the prehospital mSOFA score with a decision tree, finding lactate ≥3.8 mmol/L was the primary discriminator for 2-day in-hospital mortality, ahead of SaFi, GCS and creatinine.
-
Bedside observations beat NEWS for spotting deterioration
Retrospective analysis of 4,581 rapid response team callouts testing whether eight equipment-free bedside observations identify dying patients better than NEWS — a model built from them outperformed NEWS for predicting death within 24 hours (AUC 0.790 vs 0.707).