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53 Trends in long-term demand for emergency medical services in victoria, australia
  1. Emily Andrew1,2,
  2. Ziad Nehme1,2,3,
  3. Stephen Bernard1,2,4,
  4. Peter Cameron2,
  5. Karen Smith1,2,3
  1. 1Centre for Research and Evaluation, Ambulance Victoria, Victoria
  2. 2Department of Epidemiology and Preventive Medicine, Monash University, Victoria
  3. 3Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria
  4. 4The Alfred Hospital, Victoria


Aim Although emergency medical service (EMS) utilisation is increasing internationally, the factors driving this increase have not been well quantified using a large EMS dataset. We sought to describe long-term trends in EMS utilisation in Victoria, Australia.

Method We conducted a retrospective observational study of consecutive patients presenting to the state-wide EMS in Victoria, Australia between 01/01/2010 and 31/12/2015. We calculated incidence rates of EMS presentations using Victorian population estimates, and conducted time-series regression analysis, adjusted for temporal trends and population size.

Results A total of 2,923,815 EMS patient presentations were included. Patient presentations grew by an average of 4.3% per annum, compared with 2.0% annual growth in the Victorian population. Age-specific incidence was highest among patients aged ≥81 years although this did not grow significantly over time (2010: 517 presentations/1000 person-years vs 2015: 533/1000 person-years, p=0.8). However, the median age of patients decreased over time (2010: 60.2 vs 2015: 58.7, p<0.001). Among emergency ambulance-attended patients, 51.5% were recorded as having no comorbidities according to the Charlson Comorbidity Index, and this proportion remained steady over time (2010: 51.5% vs 2015: 51.8%). The rate of medical intervention by paramedics decreased over time (2010: 59.5% vs 2015: 46.8%, p<0.001), as did the rate of transportation to hospital (2010: 79.1% vs 2015: 77.4%, p<0.001). According to adjusted analyses, a population increase of 1000 people aged >65 years was associated with a 0.4% increase in daily EMS demand (p=0.005).

Conclusion The profile of patients presenting to EMS is changing over time, with the median age decreasing and fewer patients requiring active intervention.

Conflict of interest None

Funding None

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