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March 1999

Bridging the Emergency Medical Services for Children Information Gap

Author Affiliations

From the Department of Pediatrics, Division of Emergency Medicine, Children's Mercy Hospital (Drs Murdock, Knapp, and Dowd) and the Department of Emergency Medicine, Truman Medical Center (Dr Campbell), Kansas City, Mo.

Arch Pediatr Adolesc Med. 1999;153(3):281-285. doi:10.1001/archpedi.153.3.281

Objective  To determine the epidemiological features of pediatric usage of prehospital emergency medical services (EMS) in a defined urban population.

Methods  Residents of Kansas City, Mo, younger than 15 years who used EMS during the calendar years 1993-1995 were included. In this geographic area there is a single provider of prehospital care; all numerator data were taken from this single source. Denominator data were provided by 1995 intercensal estimates based on the 1990 US Census. Rates were calculated as an annual average and reported as the number of children transported per 1000 persons per year.

Results  There were a total of 7296 pediatric EMS transports during the study period, for an annual rate of 21.9. Infants younger than 1 year had the highest rate (47.4), followed by those aged 1 to 4 years (26.2), 10 to 14 years (17.5), and 5 to 9 years (17.3). Medicaid was the insurer for half and 27% were uninsured. One quarter of the patients used EMS more than once. Children living in ZIP codes in the lowest median income tertile were 5.8 times more likely to use EMS than those in the upper income tertile (95% confidence interval, 5.4-6.3). One third of all transports occurred between the hours of 4 and 8 PM.

Conclusions  Children using the Kansas City EMS were more likely to be infants, insured by Medicaid or uninsured, and live in low-income ZIP codes. Further study is needed to determine if this increased usage is due to greater incidence and severity of illness and injury, lack of transportation, lack of education, or other factors.