Disturbing trends: the epidemiology of pediatric emergency medical services use

Acad Emerg Med. 1999 Mar;6(3):232-8. doi: 10.1111/j.1553-2712.1999.tb00162.x.


Objective: To compare pediatric ambulance patients transported for chief complaints of suicide, assault, alcohol, and drug intoxication (SAAD) with pediatric patients transported for all other chief complaints.

Methods: An out-of-hospital database for the primary transporting service in an urban area was analyzed for patients 0-20 years of age from 1992 to 1995. Chief complaints by age, gender, and billing status were analyzed.

Results: There were 17,722 transports. The SAAD group comprised 14.9% of all transports (suicide attempt 1.6%, assault 5.9%, alcohol intoxication 3.2%, and drug abuse 4.2%). The proportion of transports due to SAAD increased with age: 0-11-year-olds (4.2%); 11-16-year-olds (17.5%); and 17-20-year-olds (20.3%) (p = 0.0001). Genders were equally represented in the overall group, while males comprised 52.6% of the SAAD transports (p = 0.032). In the SAAD group, the majority of transports for assaults (55.9%) and alcohol (58.8%) involved males, while females were the majority in transports for suicide (52.3%) and drug abuse (66%) (p = 0.0001). Reimbursement sources differed, with those in the SAAD group less likely to be reimbursed by private or public (Medicaid, government) insurance (p < 0.0001) compared with the overall group.

Conclusions: A substantial proportion of pediatric emergency medical services transports are for high-risk conditions. This patient population differs from the overall group by age distribution and reimbursement source.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Alcoholism / epidemiology
  • Ambulances / economics
  • Ambulances / statistics & numerical data*
  • Child
  • Child, Preschool
  • Emergency Medical Services / statistics & numerical data
  • Emergency Medical Services / trends*
  • Female
  • Humans
  • Infant
  • Male
  • New Mexico / epidemiology
  • Pediatrics / economics
  • Pediatrics / statistics & numerical data*
  • Pediatrics / trends
  • Retrospective Studies
  • Sex Distribution
  • Suicide, Attempted
  • Wounds and Injuries / epidemiology