The cost for an EMS run in Detroit is approx. $250. EMS is designed to transport patients with a threat to life or limb. Inappropriate utilization has been suspected, but its magnitude has not been quantified. We document the frequency of inappropriate usage by 0-36 month old patients with medical problems and the frequency of EMS usage on more than one occasion by such children. We utilized records of patients transported via EMS to the Emergency Dept. (ED) at CHM between 1/1/95 and 6/30/95. Inappropriate EMS use was defined arbitrarily by one of the following ED dispositions: 1)No Rx: surface cultures only; 2)No Rx: cbc &/or ua only; 3)Limited Rx: surface culture only: 4)Limited Rx; cbc &/or ua only, and: 5)Patient left before being seen.
Results: EMS transported 371 children 0-36 months of age with medical problems to the ED of CHM during the study period. Records were available for review from 369 runs, representing 348 patients. Inappropriate use of the system occurred in 141 runs (40%), based upon our criteria. EMS was used on more than one occasion during this period by 21 of the patients (6%) and 99 (28%) had used it more than once since birth.
