Abstract
Objective. The objective of the current study was to define the clinical anddemographic characteristics of ED patients who used ambulance transport (USERS) compared to contemporaneous non-ambulance users (NON) andto determine the reasons users gave for their choice to use ambulance transport. Methods. A single researcher queried a convenience sample of consenting ED patients regarding reasons for choice of transport to the ED, knowledge of ambulance cost, andself-estimation of illness or injury severity on a (1 most severe, 5 least severe) five-point Likert scale. We also asked if the treating physician agreed with transport choice. Results. Of 311 participants (97% response rate), USERS (N = 71, 22.8%) were older than NON (53 vs. 35, p < 0.0001) andwere more sick according to self-rated illness severity (mean rank 128 vs. 156, p = 0.02), nurse triage score (mean rank 103 vs. 153, p < 0.0001), andadmission rate (37% vs. 15%, p < 0.0001). Patient decision regarding ambulance use was associated with both having someone who called an ambulance for them andself-estimation of illness severity (or lack thereof). Physicians agreed with transport method in 68% of USERS and92% of NON (overall kappa = 0.6, p < 0.0001). Conclusions. Ambulance users were more likely to be more sick as determined by commonly used measures than nonusers. ED physicians almost always agreed with nonuse of ambulance transport andtwo-thirds of the time agreed that a patient's decision to use ambulance transport was appropriate.