PLANNING FOR AN EFFECTIVE HOSPITAL ADMINISTERED EMERGENCY AMBULANCE SERVICE IN THE CITY OF BOSTON

• NCJ Number: 10944
• Author(s): J M HOEY
• Date Published: 1973
• Length: 151 pages
• Grant Number(s): GI38004
• Sponsoring Agency: National Science Foundation
• Corporate Author: Massachusetts Institute of Technology
• Publication Format: Document
• Publication Type: Statistics
• Language: English
• Country: United States of America

Annotation

SYSTEM DESIGNED TO INCREASE THE QUALITY OF SERVICE AND TO RELEASE ALMOST ENTIRELY THE BOSTON POLICE DEPARTMENT FROM THIS NON-POLICE MEDICAL FUNCTION.

Abstract

THREE MEASURES OF EFFECTIVENESS WERE CONSIDERED RELEVANT. FIRST, RESPONSE TIME, THE TIME ELAPSING BETWEEN THE OCCURRENCE OF AN EMERGENCY AND THE ARRIVAL OF AN AMBULANCE WITH A TRAINED MEDIC, MUST BE KEPT SHORT. SECOND, BECAUSE OF THE ADVANTAGES OF EMPLOYING A SECONDARY BACK-UP SERVICE THE POLICE WILL RESPOND TO CALLS FOR AMBULANCE SERVICE ONLY WHEN NO HOSPITAL AMBULANCE IS AVAILABLE. THE AMOUNT OF AMBULANCE WORK THE POLICE PERFORM SHOULD BE NO MORE THAN 5 PERCENT OF THE TOTAL AMBULANCE RUNS. THIRD, UTILIZATION, THE FRACTION OF TIME A GIVEN AMBULANCE IS BUSY, SHOULD BE KEPT AS HIGH AS POSSIBLE WITHOUT PRODUCING UNACCEPTABLE RESULTS FOR THE OTHER TWO MEASURES, SINCE AN INCREASE IN UTILIZATION DECREASES THE COST PER AMBULANCE RUN. SINCE VARIABLE PERSONNEL COSTS ARE THE MAJOR COST CONSIDERATION, THE IMPORTANT QUESTION FOR THE TRANSPORTATION SUBSYSTEM IS NOT NUMBER OF AMBULANCE VEHICLES TO BUY, BUT NUMBER OF AMBULANCES TO MAN AT DIFFERENT TIMES OF THE DAY. DATA ON THE PRESENT LEVEL OF DEMAND FOR EMERGENCY AMBULANCE SERVICE IN BOSTON AND TEMPORAL AND SPATIAL DISTRIBUTION OF THIS DEMAND ARE USED. A QUEUING MODEL FOR DUAL SOURCE AMBULANCE SYSTEMS (HOSPITAL AMBULANCES, POLICE BACKUP) IS APPLIED HEURISTICALLY TO VARIOUS SIZED AREAS OF THE CITY IN ORDER TO GAIN INSIGHT INTO THE TRADE-OFFS INVOLVED BETWEEN RESPONSE TIME, SERVICE LEVEL, AND UTILIZATION AS THE NUMBER OF AMBULANCES ALLOCATED AND AREA SIZE CHANGE. IN SOME SECTIONS OF THE CITY THE RESPONSE TIME CRITERION IS THE MOST IMPORTANT FACTOR EFFECTING THE ALLOCATION LEVEL, WHILE SERVICE LEVEL OR UTILIZATION IS THE PRIMARY FACTOR IN OTHER AREAS. AN AMBULANCE ALLOCATION POLICY FOR BOSTON IS DEVELOPED ASSUMING THE PRESENT LEVEL OF DEMAND AS WELL AS INCREASED AND DECREASED DEMAND. SYSTEM OPERATION STATISTICS - SERVICE LEVELS, UTILIZATIONS - ARE GIVEN. FINALLY, THE COSTS ASSOCIATED WITH IMPLEMENTING AND OPERATING THE PROPOSED SYSTEM ARE CONSIDERED. (AUTHOR ABSTRACT MODIFIED)