Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Targeting top 911 callers can trim cost, improve patient care

Repeated unnecessary 911 calls are a common drain on the manpower and finances of emergency medical services, but a pilot program that identified Baltimore City's top 911 callers and coupled them with a case worker has succeeded in drastically cutting the number of such calls while helping callers get proper care.

The program, called Operation Care, was conceived and implemented by the non-profit agency Baltimore HealthCare Access and ran as a three-month pilot in 2008. Now, a newly published report of its results appearing in The American Journal of Emergency Medicine can help illuminate strategies for other emergency medical services (EMS) departments around the country that may be plagued by the same problem, says the report's lead author.

"The original idea was to help these frequent callers get better access to medical and other care and, in doing so, Baltimore City ended up saving money and resources, a welcome side effect," says lead author Michael Rinke, M.D., a pediatrician and a quality and safety expert at Johns Hopkins Children's Center.

As fire departments around the country continue to get their budgets slashed, finding ways to trim costs while maintaining the same level of service will be increasingly important, the researchers say.

In three months, the program generated savings of more than $14,300, more than $6,300 of which was for the city fire department. The real savings are probably greater, as this number did not factor in any money saved from unnecessary trips to the ER and freeing up ambulances for other callers.

The Baltimore City Fire Department, which responds to nearly 150,000 emergency calls each year, has continued to fund the program, providing a nurse and a case manager for repeat 911 callers.

In 2007, two Baltimore City residents were responsible for more than 60 emergency calls, another resident made 110 calls to 911, and yet another one made 147 such calls, the investigators say. Each 911 call requires EMS to dispatch an ambulance to the caller.

Repeated 911 callers, the researchers reasoned, may face problems such as lack of health insurance and access to routine medical care or an inability to navigate the labyrinth of healthcare services. The findings of the study suggest they were mostly right. Examining a year's worth of 911 call logs, the researchers identified Baltimore City's 25 most frequent 911 callers, 10 of whom enrolled in the three-month program for weekly sessions with a case worker who assessed their medical needs, taught them how to navigate the health care system, put them in touch with primary care physicians and specialists, referred them to various support programs and educated them on ways to limit 911 calls to true emergencies.

Collectively, the 10 callers made 520 calls to 911 in the year preceding their enrollment. Based on their call pattern from the previous year, the researchers estimated that these 10 people would make 100 calls to 911 during the three months of the program. Somewhat to the researchers' surprise, there were only 57 calls, nearly half as many as they had predicted.

Nine of the 10 patients had insurance, mostly through Medicare. All 10 patients had two or more chronic conditions, including hypertension, diabetes and heart disease. Seven had either a mental health or a substance abuse problem or both. The average age was 60 years, ranging from 39 to 89 years. The case manager referred patients to insurance assistance programs, medical specialists, adult-care services, food services like Meals on Wheels, psychiatric evaluation and support groups for substance abuse. Nearly 70 percent of the referrals were to non-medical services.

"This program highlights the importance of simple interventions that can yield powerful results," says co-investigator Kathleen Westcoat, M.P.H., of Baltimore HealthCare Access. "For example making sure that a diabetic patient doesn't run out of strips for the glucose monitor can prevent a frantic 911 call for a non-emergency."

None of the patients reported that they hesitated to call 911 in true emergencies and said that they experienced no adverse health effects as a result of the program.

The investigators caution that though these findings are insightful, their relevance is difficult to gauge because they are based on a small number of patients.

Co-investigators on the report include Elisabeth Dietrich, B.A., of the Baltimore City Health Department, now at the University of California-San Francisco; and Traci Kodeck, M.P.H., of Baltimore HealthCare Access.

Ekaterina Pesheva | EurekAlert!
Further information:

Further reports about: Baltimore EMS Healthcare chronic condition emergency calls substance abuse targeting

More articles from Health and Medicine:

nachricht NIH scientists describe potential antibody treatment for multidrug-resistant K. pneumoniae
14.03.2018 | NIH/National Institute of Allergy and Infectious Diseases

nachricht Researchers identify key step in viral replication
13.03.2018 | University of Pittsburgh Schools of the Health Sciences

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Researchers at Fraunhofer monitor re-entry of Chinese space station Tiangong-1

In just a few weeks from now, the Chinese space station Tiangong-1 will re-enter the Earth's atmosphere where it will to a large extent burn up. It is possible that some debris will reach the Earth's surface. Tiangong-1 is orbiting the Earth uncontrolled at a speed of approx. 29,000 km/h.Currently the prognosis relating to the time of impact currently lies within a window of several days. The scientists at Fraunhofer FHR have already been monitoring Tiangong-1 for a number of weeks with their TIRA system, one of the most powerful space observation radars in the world, with a view to supporting the German Space Situational Awareness Center and the ESA with their re-entry forecasts.

Following the loss of radio contact with Tiangong-1 in 2016 and due to the low orbital height, it is now inevitable that the Chinese space station will...

Im Focus: Alliance „OLED Licht Forum“ – Key partner for OLED lighting solutions

Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology FEP, provider of research and development services for OLED lighting solutions, announces the founding of the “OLED Licht Forum” and presents latest OLED design and lighting solutions during light+building, from March 18th – 23rd, 2018 in Frankfurt a.M./Germany, at booth no. F91 in Hall 4.0.

They are united in their passion for OLED (organic light emitting diodes) lighting with all of its unique facets and application possibilities. Thus experts in...

Im Focus: Mars' oceans formed early, possibly aided by massive volcanic eruptions

Oceans formed before Tharsis and evolved together, shaping climate history of Mars

A new scenario seeking to explain how Mars' putative oceans came and went over the last 4 billion years implies that the oceans formed several hundred million...

Im Focus: Tiny implants for cells are functional in vivo

For the first time, an interdisciplinary team from the University of Basel has succeeded in integrating artificial organelles into the cells of live zebrafish embryos. This innovative approach using artificial organelles as cellular implants offers new potential in treating a range of diseases, as the authors report in an article published in Nature Communications.

In the cells of higher organisms, organelles such as the nucleus or mitochondria perform a range of complex functions necessary for life. In the networks of...

Im Focus: Locomotion control with photopigments

Researchers from Göttingen University discover additional function of opsins

Animal photoreceptors capture light with photopigments. Researchers from the University of Göttingen have now discovered that these photopigments fulfill an...

All Focus news of the innovation-report >>>



Industry & Economy
Event News

Virtual reality conference comes to Reutlingen

19.03.2018 | Event News

Ultrafast Wireless and Chip Design at the DATE Conference in Dresden

16.03.2018 | Event News

International Tinnitus Conference of the Tinnitus Research Initiative in Regensburg

13.03.2018 | Event News

Latest News

Natural enemies reduce pesticide use

21.03.2018 | Life Sciences

Make way for the mini flying machines

21.03.2018 | Life Sciences

Taming chaos: Calculating probability in complex systems

21.03.2018 | Physics and Astronomy

Science & Research
Overview of more VideoLinks >>>