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Pediatric Out-of-hospital Emergency Medical Services Utilization in Kansas City, Missouri
Article first published online: 6 MAY 2009
DOI: 10.1111/j.1553-2712.2009.00418.x
© 2009 by the Society for Academic Emergency Medicine
Additional Information
How to Cite
Miller, M. K., Denise Dowd, M., Gratton, M. C., Cai, J. and Simon, S. D. (2009), Pediatric Out-of-hospital Emergency Medical Services Utilization in Kansas City, Missouri. Academic Emergency Medicine, 16: 526–531. doi: 10.1111/j.1553-2712.2009.00418.x
Publication History
- Issue published online: 1 JUN 2009
- Article first published online: 6 MAY 2009
- Received October 28, 2008; revisions received January 8 and January 15, 2009; accepted January 19, 2009.
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Keywords:
- pediatric emergency medicine;
- prehospital care;
- emergency medical services for children
Abstract
Objectives: The objective was to describe epidemiologic features and usage patterns of pediatric emergency medical services (EMS) transports in Kansas City, Missouri.
Methods: The study consisted of a retrospective analysis of transports from January 1, 2002, to December 31, 2004, for Kansas City, Missouri, residents younger than 15 years of age (excluding interfacility transports. Data included demographics, insurance, day and time of transport, patient zip code, chief complaint, and number of individual transports. Rates were calculated using intercensal estimates for the denominator. All rates were expressed as number of transports per 1,000 persons per year (PPY).
Results: A total of 5,717 pediatric transports occurred in the 3-year study period. Transport rates were 18 PPY for all users, 42 PPY for those <1 year old, 23 PPY for ages 1–4 years, 12 PPY for ages 5–9 years, and 14 PPY for ages 10–14 years. Infants <1 year were more likely than children aged 5–9 years to use EMS (relative risk [RR] = 3.7, 95% confidence interval [CI] = 3.4 to 4.0). Males were more likely than females to use EMS (RR = 1.2, 95% CI = 1.1 to 1.3). Most (64%) were insured by Medicaid. Transports peaked between 4 pm and 8 pm, and lowest usage was 4 am to 8 am (p < 0.001). Overall usage did not vary by weekday or season. Respiratory transports were more common in the fall and winter, while trauma transports were more common in the summer (p < 0.001). The most common diagnoses were trauma (27%), neurologic (19%), and respiratory (18%). Eleven percent of users accessed EMS more than once (26% of all transports). There was a significant inverse linear relationship between transport rate and median family income by zip code (r = −0.36, p < 0.001).
Conclusions: Children in zip codes with lower incomes, infants, and males were more likely to use EMS. Factors related to these increased transport rates are unknown.