10/15/12

Ambulances spending 21% more time in hospitals

The new Ontario Municipal Benchmarking Initiative public report  indicates that ambulances (and by extension paramedics) are spending more and more time in hospitals.  For the thirteen (mostly large) Ontario communities included, the median percentage of time ambulances spend in hospitals has increased from 15.5% in 2009, to 17.8% in 2010, to 18.7% in 2011.

That's an increase by more than one-fifth in the amount of time spent in hospitals.

As the report notes "the more time paramedics spend in the hospital process equates to less time that they are available on the road."  Ambulance hospital off-load delays are a major part of the problem, as hospitals with too few beds lead to clogged emergency rooms that are unable to deal with newly arriving patients.

There is also some more positive news about improving EMS capacity:

  • The number of hours of ambulance service per thousand population has increased from 343 hours in 2009 to 350 hours in 2011, a 2% increase.
  • The number of calls responded to by EMS per thousand population has increased from 98 in 2009 to 107 in 2011, a 9.2% increase.
  • There was a decrease in the time it takes to dispatch 90% of EMS calls, shrinking from 2 minutes 56 seconds in 2009 to 2:51 in 2011. This is a 2.84% decrease over two years. 
  • The time for 90% of ambulances to arrive on the scene for the highest priority calls (from the time of the original 911 call) has decreased from 10 minutes 59 seconds in 2010 to 10:41 in 2011.  This is a one-year decrease of 2.8%.  (No report for 2009 was made.) 
But more capacity has driven up costs. The total cost for ambulance service (including administration, medical supplies, building operation, supervision and overhead) has increased from $168 per hour in 2009 to $181 per hour in 2011, a 7.7% increase.  

The report also indicates that the total cost for a "fire vehicle" in the included urban communities (where there are professional firefighters) has increased from $274 per hour in 2009 to $305 per hour, an 11.3% increase.   On this report, one hour of urban "fire vehicle" service is 68% more expensive than one hour of ambulance service  This is up from 63% more expensive in 2009.  

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