Is 911 The Answer? A Retrospective Review of Emergency Medical Services Use by Home Care Providers

Sandra McKay; Emmelie Mohammed; Meghla Roy; Vivian Hung; Matthew Wong; Bonnie Lum; Emily C King

doi:10.1177/11786329231178767

Is 911 The Answer? A Retrospective Review of Emergency Medical Services Use by Home Care Providers

Health Serv Insights. 2023 May 30:16:11786329231178767. doi: 10.1177/11786329231178767. eCollection 2023.

Authors

Sandra McKay^{1

2

3

4}, Emmelie Mohammed⁴, Meghla Roy⁴, Vivian Hung⁴, Matthew Wong⁴, Bonnie Lum⁴, Emily C King^{4

5}

Affiliations

¹ Institute of Health Policy Management & Evaluation, University of Toronto, Toronto, ON, Canada.
² Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.
³ Ted Rogers School of Management, Toronto Metropolitan University, Toronto, ON, Canada.
⁴ VHA Home HealthCare, Toronto, ON, Canada.
⁵ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

Abstract

With the Ontario healthcare system under strain the use of resources-particularly emergency medical services (EMS) is an increasing focus. Recent work has identified long-term care facilities as high users of EMS despite access to health-related support outside of the hospital. However, such insights are not available for home care. A retrospective review of administrative records of EMS calls drawn from over 6 million visits by home care providers found relatively low call rates: 8.4 calls per 100 000 personal support visits, 4.1 calls per 100 000 for rehabilitation providers, and 0.9 calls per 100 000 for nurses. The majority (85%) of calls resulted in transport to the hospital; the notable exception was fall-related events, and of these falls, a third (32%) were treated at home. Classification of reported physical symptoms suggests opportunities for leveraging in-home clinical specialists to avoid hospital transport where possible and preserve EMS capacity to respond to the most urgent and severe events.

Keywords: Home care; ambulance services; community care; health services; patient flow.