ABSTRACTS
The Impact of 9-1-1 Demand and Population Growth on Urban EMS StaffingAuthor: Nate Andrews | | Associate Authors: Jackson D. Déziel
Introduction Population growth in the United States, combined with an ever-aging population, is forecast to increase the demand for emergency medical services (EMS). Subsequently, more prehospital providers will be required to promptly manage this increase in demand. Although prior research has identified the impact population growth has on EMS call volume, the relationship between these factors and EMS staffing are unknown. Objective This study sought to identify the impact that population and call volume have on full-time equivalencies (FTEs) for urban EMS agencies. Methods These data are a secondary analysis of population and call volume data collected from urban EMS agencies across the southeastern United States. Only the agencies reported staffing data for the time-period January 2010 through December 2017 were included for analysis. FTEs, monthly call volume, and population were log-transformed (natural log) to derive an elasticity function. A pooled ordinary least squares model with fixed effects was utilized for tests of inference. Results A total of 98 observations were analyzed. Linear regression models demonstrate for a 10% increase in call volume, the number of FTEs increases by 6.6% (95% CI: 4.19-9.07; P < 0.0001). In practical terms, an increase of 100 calls results in an increase of 1.8 FTEs. A 10% increase in population resulted in a 2.8% decrease in FTEs (95% CI: –4.74- –0.90; P = 0.005). A 1000-person increase in population results in a 0.08 decrease in FTEs. Although statistically significant, population growth bears minimal practical significance for determining FTE requirements. These findings indicate that call volume is a superior metric for determining future FTE requirements. Conclusion This study is the first to quantify the relationship that population and call volume may have on the coordination of EMS staffing. Findings indicate that EMS agencies increase staffing in response to increases in call volume. This finding is an important consideration as EMS agencies navigate impending increases in demand for prehospital services. Further research is necessary to identify the impact of call volume on rural EMS staffing, as well as best practices for increasing and optimizing EMS staffing.
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