Ambulance use for low-acuity conditions by long-term care facilities for older adults

Eur Geriatr Med. 2020 Oct;11(5):777-782. doi: 10.1007/s41999-020-00333-y. Epub 2020 May 26.

Abstract

Purpose: Increased ambulance calls affect the timely transportation of patients. Recently, ambulance uses from long-term care facilities (LTCFs) for older adults has been increasing. The aim of this study was to investigate to what extent LTCFs used ambulances for low-acuity conditions.

Methods: Ambulance records from the fire department of Misato City were used. The participants were patients aged 65 years or older transported from all types of LTCFs (including public nursing homes, geriatric health services facilities, private nursing homes, and group homes) and homes. The proportions of ambulance use for low-acuity conditions and their 95% confidence intervals (CI) were calculated and compared by time (daytime and night-time) and day (weekdays and holidays) of ambulance use for each type of residence.

Results: Of 12,494 participants, 1336 (11%) were transported from LTCFs, and 326 (2.6%) for low-acuity conditions. Of 326 patients with low-acuity conditions, 69% were transported from LTCFs. The proportion of low-acuity conditions was 17% among those transported from LTCFs, while it was only 1% among those from homes. The proportion of low-acuity conditions was significantly greater during night-time than daytime among those from public nursing homes, geriatric health services facilities, and group homes, while this proportion was greater on weekdays than holidays among those from geriatric health services facilities.

Conclusion: This study found a large number of instances of ambulance use for low-acuity conditions by LTCFs. To reduce unnecessary ambulance use for low-acuity conditions efficiently, LTCFs should be assisted in making proper assessments of both patients' conditions and appropriate ambulance use.

Keywords: Acuity; Ambulance; Emergency medical service; Long-term care facility; Triage.

MeSH terms

  • Aged
  • Ambulances*
  • Health Services for the Aged*
  • Humans
  • Long-Term Care
  • Nursing Homes
  • Skilled Nursing Facilities