EMS TRANSPORTATION GUIDELINES
The healthcare field is very dynamic. During the last few years this is becoming more readily apparent than ever before. As the nation tries to deal with the ever-increasing costs associated with health care, Central Ohio EMS providers have been trying our best to find workable solutions to limited bed availability in area hospitals.
During the first decades of EMS in central Ohio persons needing to be transported for acute illness or injury were likely transported to the closest emergency room (ER). Exceptions were made for special cases, including pediatrics and burns. These patients would be taken to a Children's ER or a burn center, respectively. In an effort to improve the level of service to our community, Worthington Fire began taking persons needing transportation to the ER of their choice in many cases. This change was made over 10 years ago, and now many other area EMS providers do likewise.
In cases where a patient is critically ill or has special care needs
(pediatrics, burns, trauma, etc.) crews will take a person to the nearest ER
with resources to manage their given emergency. This may or may not be the
closest ER. However, in all cases crews transport to the ER that is best suited
to care for the patient's immediate needs. Later, after stabilization, a
patient may be transported to a different hospital should that be necessary.
Now having said this, recent trends are putting increasing demands on the EMS providers in Central Ohio. The reasons for these changes are many and complex. The result is many area hospitals routinely close their doors to stable patients being brought in by local EMS. They simply do not have staff or beds available to care for additional patients. When several hospitals close their doors at the same time, local EMS providers use system called the "Emergency Transport Plan" to distribute patient loads fairly to all area hospitals. All the local ERs voluntarily participate in this system which has been in place for several years.
Should you ever require transportation by our EMS service, this means you may experience any of the following :
- If all area ERs are open, we will try to transport you to the facililty of your choosing, or the one that is most appropriate for your specific health care needs.
- If some area ERs are closed, we may not be able to transport you to the hospital of your choice. This is beyond our control. We will transport you the closest hospital with necessary resources to provide you optimal care.
- If several area ERs are closed and we are in the "Emergency Transport Plan", we may have limited choices in where we will be able to transport you. We can still transport to near ERs for critically ill patients or specialized ERs for patients with special care needs.
Fee For Service
To increase revenues several area EMS providers have begun charging a 'fee for service' during the recent past. Our single fire station has personnel available for only three response pieces at any given time - only two of these are transport capable. When crews are busy on fire, rescue or other EMS calls, additional EMS responses are handled by neighboring Departments. Should one of these other Departments respond to your medical emergency, you may receive a bill for their services. Worthington Fire & EMS is presently tax based, but this will change in early 2005 when we begin billing for service as well.
What the Future Holds
The various transportation options oultined above, and fee for service, are the end result of rising healthcare costs. Our Department is committed at remaining dynamic and providing the best level of service we can given local realities. However, when healthcare costs rise in a manner that out-paces the rest of the economy, nobody wins. Local healthcare providers, EMS systems, and hospitals all want to continue improving the level of service they provide their communities, but methods for reducing costs and/or increasing revenues must be found. Perhaps the single largest factor driving soaring costs is the healthcare liability insurance expenses which are passed on to patients. Many feel the current court system in this country encourages litigation and without reform these costs will likely continue to rise. It's up to an informed citizenry to take a long look at this complex problem and to hold politicians accountable for developing real solutions to this crisis . . . before quality healthcare becomes too expensive for the average worker.