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Drivers of Increasing Emergency Ambulance Demand

机译：提高紧急救护车需求的司机

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Objectives: Although the factors driving emergency department demand have been extensively investigated, a comparatively minimal amount is known about the factors that are driving an increase in emergency ambulance demand. Methods: We conducted a retrospective observational study of consecutive cases attended by Ambulance Victoria in Melbourne, Australia from 2008 to 2015. Incidence rates were calculated, and adjusted time series regression analyses were performed to assess the driving factors of ambulance demand. Results: A total of 2,443,952 consecutive cases were included. Demand grew by 29.2% over the 8-year period. The age-specific incidence increased significantly over time for patients aged = 60 years. After adjustment for seasonality and population growth, demand increased by 1.4% per annum (incident rate ratio [IRR] = 1.014 [1.011-1.017]). The largest annual growth in demand was observed in patients with a history of mental health issues (IRR = 1.058 [1.054-1.062]), alcohol/drug abuse (IRR = 1.061 [1.056-1.066]), or a Charlson Comorbidity Index [CCI] score >= 4 (IRR = 1.045 [1.039-1.051]). Cases involving patients of relative socio-economic/educational disadvantage, younger age, or with no preexisting health conditions according to the CCI also grew faster than the overall patient population. Cases requiring transport to hospital increased by 1.2% annually (IRR = 1.012 [1.009-1.016]), although patients not requiring medical intervention from paramedics increased by 6.7% annually (IRR = 1.067 [1.063-1.072]). Conclusions: Increases in ambulance demand exceeded population growth. Emergency ambulances were increasingly utilized for transport of patients who did not require medical intervention from paramedics. Identifying the characteristics of patients driving ambulance demand will enable targeted demand management strategies.
机译：目的：虽然推动了急诊部门需求的因素已被广泛调查，但是对驾驶紧急救护车需求增加的因素是相对较低的金额。方法：我们从2008年到2015年澳大利亚墨尔本驻救护车救护车维多利亚驻救护车的连续案例进行了回顾性观察研究。计算发病率，并进行调整时间序列回归分析，以评估救护车需求的驱动因素。结果：共有2,443,952例连续案件。 8年期间需求增长了29.2％。年龄特异性发病率随着时间的推移而增加，患者= 60岁。调整季节性和人口增长后，每年需求增加1.4％（入射率比[IRR] = 1.014 [1.011-1.017]）。心理健康问题历史的患者中最大的需求（IRR = 1.058 [1.054-1.062]），酒精/药物滥用（IRR = 1.061 [1.056-1.066]），或CCI分数> = 4（IRR = 1.045 [1.039-1.051]）。涉及相对社会经济/教育劣势，年龄较小的患者，或根据CCI没有预先存在的健康状况的案件也比整体患者人口增长得更快。需要运送到医院的案件每年增加1.2％（IRR = 1.012 [1.009-1.016]），尽管未要求医疗人员的医疗干预的患者每年增加6.7％（IRR = 1.067 [1.063-1.072]）。结论：救护车需求的增加超过人口增长。急救救护车越来越多地用于运输不需要医疗主题医疗干预的患者。确定驾驶救护车需求的患者的特征将实现有针对性的需求管理策略。

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