# The way back home: The invisible burden of the emergency healthcare services

## TL;DR

This study examines the costs and impact of ambulance services transporting patients from hospitals to home in Turkey, highlighting the burden on emergency services.

## Contribution

The study provides insights into the cost and workload implications of hospital-to-home ambulance transports in Turkey.

## Key findings

- 11.4% of ambulance transports during the study period were hospital-to-home transfers.
- Social indication cases accounted for 16.26% of total costs despite being 9.7% of transfers.
- The study suggests that home transport should be medically indicated to avoid overburdening emergency services.

## Abstract

Ambulance services around the world vary according to regional, cultural and socioeconomic conditions. Many countries apply different health policies locally. In Turkey, transportation from hospital to home has started to form an important part of ambulance services in recent years. The increase in the number of patients whose treatment has been completed and waiting to be referred may hinder the work of the emergency services. The aim of this study was to examine the costs, indications, and impact on workload of patients sent home by ambulance. Patients were divided into two groups according to the reasons for referral. The distance to home, transport time and cost were calculated according to the reasons for transport. Patients who were transferred to other clinics or hospitals by ambulance were excluded from the study. The findings showed that the hospital-to-home transfer rate during the study period was 11.4%. Although 9.7% of all cases transferred from our hospital to home were due to social indications, these cases accounted for 16.26% of the total costs. These results suggest that providing home transport services to selected patient groups for medical reasons should be seen as part of the treatment. However, the indications for home transport should not be exceeded and an additional burden should not be placed on the fragile health service.