Niagara EMS sends taxis instead of ambulances for some calls

Niagara Emergency Medical Services sends taxis instead of ambulances for some calls, to relieve pressure on paramedics and emergency services.

EMS Mobile Integrated Health Commander Marty Mako said paramedics started the pilot on Dec. 31. Central Taxi will provide those in need with a ride to medical appointments when they have no other way to get there.

“Many Niagara residents are not getting the medical care they need primarily because of a transportation barrier,” Mako told the Niagara Region Public Health and Social Services Committee on Tuesday.

As a result, he said, residents sometimes call 911 for an ambulance because they need to be transported to the hospital, but might not need paramedic care on the way.

“This initiative also helps preserve ambulance capacity and hospital emergency department capacity at a time when both systems, I’m sure you know, are significantly stressed and strained,” Mako said.

The program was operated 100 times by emergency communication nurses and 30 times by mobile integrated health personnel, providing transportation for residents of nine Niagara municipalities.

Mako said most of these patients suffered from back pain, anxiety and symptoms of upper respiratory infection.

He said all trips must also begin and end in Niagara. So far, most have been relatively short journeys within the same municipality, averaging 9.7 kilometers.

“Patient satisfaction has been high with the new service, which is good for us to see, and more importantly, there have been no reported adverse patient outcomes,” Mako said.

He said there are significant savings associated with the program.

An ambulance costs about $1,006 per trip to the hospital, while an emergency room visit, even for minor ailments, costs about $276 per visit. By comparison, the average taxi ride since the program began is $15 to $20 each.

He said a $10,000 investment in the program would result in savings of approximately $206,000.

But accessing the service isn’t as easy as calling 911 and asking for a ride.

“There’s a really thorough process before that happens,” he said.

Mako said the program has been used in cases where a patient has called 911 for non-emergency situations, and is determined to need an evaluation by a medical professional within the next 12 hours, but he can’t access it.

Once alternatives have been ruled out, such as traveling with family or friends or public transport, and the patient has no other choice, and the patient meets “all of our eligibility criteria strict medical procedures, only then will Niagara EMS call a taxi”.

In the past, he said an ambulance would have been dispatched for patients in these circumstances.

“I have to point out that it’s offered,” Mako said. “If the person is really adamant and says, ‘No, I would really prefer an ambulance,’ they can still get transported by an ambulance.”

In some cases, the program has been used for registered patients with scheduled medical appointments that they are likely to miss due to lack of transportation.

“We know that’s how people slowly deteriorate over time by not keeping proactive medical appointments,” he said.

Mako said that to his knowledge, the pilot program is the first of its kind to be implemented in Canada.

“Since we implemented it, we have received many requests from other departments.

“I feel like this is not a unique situation, with transportation being a barrier across the province and across the country,” he said. “A lot of eyes are on this to see how it performs, and I can see it being duplicated by others in the years to come.”

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