School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC. Judy.LowthianATmonash.edu
Med J Aust. 2011 Jun 6;194(11):574-8. doi: 10.5694/j.1326-5377.2011.tb03107.x.
To measure the growth in emergency ambulance use across metropolitan Melbourne since 1995, to measure the impact of population growth and ageing on these services, and to forecast demand for these services in 2015.
A population-based retrospective analysis of Ambulance Victoria's metropolitan emergency ambulance transportation data for the period from financial year 1994-95 to 2007-08, and modelling of demand in the financial year 2014-15.
Numbers and rates of emergency ambulance transportations.
The crude annual rate of emergency transportations across all age groups increased from 32 per 1000 people in 1994-95 to 58 per 1000 people in 2007-08. The rate of transportation for all ages increased by 75% (95% CI, 62%-89%) over the 14-year study period, representing an average annual growth rate of 4.8% (95% CI, 4.3%-5.3%) beyond that explained by demographic changes. Patients aged ≥ 85 years were eight times (incident rate ratio, 7.9 [95% CI, 7.6-8.3]) as likely to be transported than those aged 45-69 years over this period. Forecast models suggest that the number of transportations will increase by 46%-69% between 2007-08 and 2014-15, disproportionately driven by increasing usage by patients aged ≥ 85 years.
These findings confirm a dramatic rise in emergency transportations over the study period, beyond that expected from demographic changes. Rates increased across all age groups, but more so in older patients. In the future, such acceleration is likely to have major effects on ambulance services and acute hospital capacity. This calls for further investigation of underlying causes and alternative models of care.
测量自 1995 年以来墨尔本大都市地区紧急救护车使用量的增长情况，测量人口增长和老龄化对这些服务的影响，并预测 2015 年这些服务的需求。
基于人口的回顾性分析，对维多利亚救护车大都市地区紧急救护车运输数据进行分析，时间段为 1994-95 财政年度至 2007-08 财政年度，并对 2014-15 财政年度的需求进行建模。
紧急救护车运输的数量和比率。
所有年龄段的紧急运输的粗年率从 1994-95 年的每 1000 人 32 人增加到 2007-08 年的每 1000 人 58 人。在 14 年的研究期间，所有年龄段的运输率增加了 75%（95%可信区间，62%-89%），这一增长率比人口变化所解释的增长率高出 4.8%（95%可信区间，4.3%-5.3%）。在这段时间里，年龄≥85 岁的患者被转运的可能性是 45-69 岁患者的 8 倍（发病率比，7.9 [95%可信区间，7.6-8.3]）。预测模型表明，2007-08 年至 2014-15 年期间，运输数量将增加 46%-69%，这主要是由于年龄≥85 岁的患者使用量增加所致。
这些发现证实了研究期间紧急运输量的急剧增加，这超出了人口变化所预期的增加。所有年龄段的比率都有所增加，但在老年患者中更为明显。在未来，这种加速可能会对救护车服务和急性医院容量产生重大影响。这需要进一步调查潜在原因和替代护理模式。
