Columbia University, Mailman School of Public Health, New York, NY 10032, USA.
Health Econ. 2013 Jul;22(7):790-806. doi: 10.1002/hec.2851. Epub 2012 Jun 14.
The introduction of technology aimed at reducing the response times of emergency medical services has been one of the principal innovations in crisis care over the last several decades. These substantial investments have typically been justified by an assumed link between shorter response times and improved health outcomes. However, current medical research does not generally show a relationship between response time and mortality. In this study, we explain the discrepancy between conventional wisdom and mortality; existing medical research fails to account for the endogeneity of incident severity and response times. Analyzing detailed call-level information from the state of Utah's Bureau of Emergency Medical Services, we measure the impact of response time on mortality and hospital utilization using the distance of the incident from the nearest EMS agency headquarters as an instrument for response time. We find that response times significantly affect mortality and the likelihood of being admitted to the hospital, but not procedures or utilization within the hospital.
引入旨在缩短紧急医疗服务响应时间的技术是过去几十年危机护理的主要创新之一。这些大量的投资通常可以通过假设响应时间缩短与改善健康结果之间的联系来证明是合理的。然而，目前的医学研究通常没有显示响应时间与死亡率之间的关系。在这项研究中，我们解释了传统智慧与死亡率之间的差异；现有的医学研究没有考虑到事件严重程度和响应时间的内生性。我们分析了来自犹他州紧急医疗服务局的详细呼叫级信息，使用事件与最近的 EMS 机构总部之间的距离作为响应时间的工具，来衡量响应时间对死亡率和住院利用率的影响。我们发现，响应时间会显著影响死亡率和住院的可能性，但不会影响医院内的程序或利用率。
