WASHINGTON — A new national study published by Health Affairs Scholar and Oxford University Press suggests that a small group of repeat 911 callers places a disproportionate demand on EMS systems, with researchers arguing that frequent EMS use is more closely tied to gaps in healthcare access than misuse of emergency services.
Researchers analyzed more than 9.5 million 911 EMS encounters involving 6.6 million unique patients from the 2024 ESO Data Collaborative. They found that approximately 3% of patients accounted for 16% of all EMS responses. The highest-use patients, those with 12 or more EMS encounters during the year, typically returned to the system within a median of just 10 days.
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The study found that frequent EMS users were more likely to be enrolled in Medicaid, live in socioeconomically vulnerable communities and have chronic medical conditions. Although they were transported to hospitals more often than patients with a single EMS encounter, they were about 40% less likely to be admitted after arriving at the emergency department.
“EMS practitioners have seen this in the field for years, and now this research quantifies their experience at a national scale: A concentrated group of people is turning to 911 again and again to access healthcare,” Brent Myers, M.D., MPH, chief medical officer at ESO and a co-author of the study, said in a statement. “These data give the emergency care continuum an earlier, community-based signal for who those patients are and a chance to connect them to the right care in a patient-centered manner.”
The authors suggest the findings support expanded use of community paramedicine, mobile integrated healthcare programs and alternative reimbursement models that allow EMS agencies to connect high-need patients with primary care, behavioral health and social services instead of relying solely on emergency department transport. They also call for improved data sharing across healthcare systems to coordinate care for patients with recurring EMS needs.
The findings are based on data from the ESO Data Collaborative, which includes more than 3,000 participating EMS agencies nationwide. Researchers cautioned that because participation in the collaborative is voluntary, the results reflect trends within the dataset and should not be considered nationally representative. They also noted that, as an observational study, the analysis identifies associations but cannot determine cause-and-effect relationships.
A national description of emergency medical services patient utilization patterns by Lexipol_Media_Group
