Association between prepayment systems and emergency medical services use among patients with acute chest discomfort syndrome

David B. Siepmann, N. Clay Mann, Jerris R. Hedges, Mohamud Ramzan Daya

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Study objective: Cost concerns may inhibit emergency medical services (EMS) use. Novel tax-based and subscription prepayment programs indemnify patients against the cost of EMS treatment and transport. We determine whether the presence of (or enrollment in) prepayment plans increase EMS use among patients with acute chest discomfort, particularly those residing in low-income areas, those lacking private insurance, or both. Methods: This study uses a subset of baseline data from the REACT trial, a multicenter, randomized controlled community trial designed, in part, to increase EMS use. The sample includes 860 consecutive noninstitutionalized patients (>30 years old) presenting with nontraumatic chest discomfort to hospital emergency departments in 4 Oregon/Washington communities. The association between prepayment systems and EMS use was analyzed using multivariable logistic regression. Results: Overall EMS use was 52% (n=445). Among EMS users, 338 (75%) were subsequently admitted to the hospital and 110 (25%) were released from the ED. Prepayment was not associated with increased EMS use in the overall patient sample. However, patients residing in low-income census block groups (median annual income

Original languageEnglish (US)
Pages (from-to)573-578
Number of pages6
JournalAnnals of Emergency Medicine
Volume35
Issue number6
StatePublished - 2000
Externally publishedYes

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Acute Chest Syndrome
Emergency Medical Services
Thorax
Costs and Cost Analysis
Taxes
Hospital Departments
Censuses
Insurance
Multicenter Studies
Hospital Emergency Service
Randomized Controlled Trials
Logistic Models

ASJC Scopus subject areas

  • Emergency Medicine

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Association between prepayment systems and emergency medical services use among patients with acute chest discomfort syndrome. / Siepmann, David B.; Mann, N. Clay; Hedges, Jerris R.; Daya, Mohamud Ramzan.

In: Annals of Emergency Medicine, Vol. 35, No. 6, 2000, p. 573-578.

Research output: Contribution to journalArticle

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