ABSTRACTS
Review of EMS Call Characteristics and Social VulnerabilityAuthor: Amoha Bhale B.S., M.A. | EMS Call Characteristics and Social Vulnerability in the United States: A Retrospective Study | CARESTAR–PCRF Research Workshop, UCLA Center for Prehospital Care Associate Authors: Bhale, Amoha, B.S., M.A. | Tan, Joycelyn, B.S., EMT-B | Lips, Kristin, M., M.A. | Dooley, Naomi, L., B.S., EMT-B | Malik, Ashleyn, B.S., M.A., EMT-B | Strange, Jackelyn, F., EMT-P | Green, Alyssa, M., M.S., EMT-P
Background Emergency Medical Services(EMS) assumes the burden of inefficient health systems. Previous research indicates high social vulnerability translates to poor health outcomes. Gaps exist in research connecting Social Vulnerability Index(SVI) scores and EMS in the US. Our objective is to describe the differences in EMS call characteristics by SVI scores. Methods This retrospective study analyzed the 2023 ESO Data Collaborative for 9-1-1 incidents with patient contact and linked SVI data. We included patients with medical primary impression and either: a low SVI(L-SVI) score(0-0.25) or high SVI(H-SVI) score(0.75-1). Median and interquartile range(IQR) for call volume density measured per 10,000 population was reported using population data from SVI database. Descriptive statistics reported comparing H-SVI and L-SVI by gender, race/ethnicity, age, and primary impression. Results Out of 9,843,217 9-1-1 incidents with patient contact, 1,657,120(16.8%) met inclusion criteria. Over half of patients(59%,n=975,631) were in the H-SVI group. Call volume density increased in H-SVI compared to L-SVI(552, IQR:[27,1271] vs 292, IQR:[21,577] respectively). Patients aged 60+ constitute 60% of the L-SVI group compared to 41% in the H-SVI group. There is little variation between groups by gender with 51% female in the H-SVI group compared to 52% in L-SVI. The H-SVI group had much higher proportions of Black/African American and Hispanic/Latino(40% and 13% respectively) than the L-SVI group(11% and 6.6% respectively). The proportion of diabetic primary impressions in the H-SVI group is 47.4% higher than the L-SVI group. Conversely, the proportion of strokes in the H-SVI group is 28.6% lower than in the L-SVI group. Conclusion EMS call characteristics vary by SVI score, underscoring an intersection between EMS and public health. An 89% increase in call volume density in H-SVI regions highlights the disproportionate need for EMS in under-resourced settings. Variations in primary geriatric impressions suggest differences in age-related comorbidities by SVI. Limitations include unstandardized definitions for gender/sex and primary impressions. Health systems should consider social vulnerability in relation to EMS resource distribution.
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