Repeat ambulance use by pediatric patients

Objective: To compare pediatric patients transported by ambulance on more t han one occasion (repeat) with those transported only once. Methods: The au thors analyzed pediatric (patient < 21 years old) transports for 1992-1995 by the ambulance service that provides 99% of transports for a non-inner-ci ty metropolitan area. Repeat transports were compared with single transport s with regard to patient age, gender, chief complaint, and payment source. Results: There were 17,448 transports involving 15,168 patients. Nearly hal f (49.0%) of the repeat transports involved patients in the oldest age cate gory, 17 to 20.9 years, contrasted with 38.0% of single transports (p < 0.0 0001). Females comprised 51.4% of the repeat transports and 48.5% of the si ngle transports (p = 0.0008). Traumatic complaints accounted for one-third (33.0%) of the repeat transports and half (51.1%) of the single transports (p < 0.0001). Chief complaints of the patients with repeat transports were more likely to be seizure, assault, abdominal pain, and respiratory problem s, and less likely to be falls and motor vehicle-related complaints, than c hief complaints of the patients with single transports (p < 0.0001). More t han one-third (39.0%) of the repeat transports were funded by Medicaid, in contrast with 19.8% of the single transports (p < 0.0001). Conclusions: Com pared with single transports, repeat transports were more likely to involve patients more than 16 years of age, female, and with a chief complaint of seizure, assault, abdominal pain, or respiratory distress, and more likely to be funded by public insurance (Medicaid). Repeat pediatric transports wa rrant further investigation. This information may be useful in designing in terventions targeted at reducing emergencies and hence ambulance use.