# Effectiveness of Hospital Ambulance Utilization in a Community-Based Integrated Care System

## TL;DR

Hospital ambulances help transfer older patients to chronic care hospitals, reducing the workload on fire department ambulances and supporting community-based care.

## Contribution

Demonstrates how hospital ambulances can optimize emergency resource use and support integrated care systems.

## Key findings

- Hospital ambulances were primarily used for interhospital transfers and home-to-hospital transports.
- Fractures and orthopedic disorders were the most common reasons for ambulance calls.
- Increased use of hospital ambulances reduced reliance on fire department ambulances for transfers.

## Abstract

Background and objectives

In recent years, the number of emergency transports for older patients has significantly increased, raising concerns about the strain on emergency medical services. This study aimed to assess whether the use of hospital ambulances can enhance collaboration between home medical care and hospitals while reducing the reliance on fire department ambulances for interhospital transfers.

Methods

This retrospective observational study analyzed 3,983 hospital ambulance dispatches from December 1, 2014, to March 31, 2024. We examined the annual dispatch volume, reasons for dispatch requests, types of transportation, and receiving medical institutions. We then compared the acceptance of ambulance transport and the frequency of interhospital transfers performed by hospital ambulances versus fire department ambulances at chronic care hospitals within the city.

Results

The number of ambulance calls increased annually until 2020 but began to decline in 2021 following the introduction of restrictions on transporting patients with COVID-19. Fractures and orthopedic disorders were the most common reasons for calls (1,040 cases, 26.1%). Interhospital transfer was the most frequent type of transport (1,514 cases, 38.0%), followed by transport from home to the hospital (1,096 cases, 27.5%). Overall, 2,179 patients (54.7%) were transferred to chronic care hospitals, with 3,752 (94.2%) remaining within the city. Regarding the number of ambulances accepted by chronic care hospitals and interhospital transfers, an increase in hospital ambulance utilization and a decrease in fire department ambulance utilization were observed until 2021 and 2020, respectively; however, these trends reversed thereafter.

Conclusion

The use of hospital ambulances facilitates patient transfers to chronic care hospitals and alleviates the burden on fire department ambulances, particularly for interhospital transfers. Hospital ambulances could serve as pivotal tools for reinforcing community-based care while optimizing the use of limited emergency resources.