Demand for ambulance services up in Ontario over last decade, study finds

Ontarians demand for paramedic and ambulance services has increased almost 40 per cent in the last decade and is exceeding population growth in the province, a new report says.

The study, led by a McMaster University PhD candidate and published in the Canadian Journal of Emergency Medicine, also revealed that increases in paramedic transports outpaced emergency department (ED) walk-ins between 2010 and 2019 by over 20 per cent, with most admissions being those 65 years or older.

“We do find that the older age cohort is using up more and more ambulance services each year,” said Ryan Strum, lead author of the study.

“If you look down the road, you think about how the population is going to be aging in Ontario, this could only be exacerbated as we go forward.”

Data from 2019 alone showed two in five people in the province over the age of 65 called for an ambulance that year and accounted for nearly half of all calls (43.7 per cent).

The Hamilton Niagara Haldimand Brant health region had the highest number of patients transported that year at 11.7 per cent out of all of the 14 health regions.

South and central Ontario health networks accounted for the largest proportion of transports, with 53.4 per cent of transports made in the areas in 2019.

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The McMaster study, which included input from ICES researchers, was spurred on by the COVID-19 pandemic. Researchers wanted to see if the pressure experienced by hospitals since the pandemic began was a new phenomenon or something that has occurred in the past.

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Strum says the data also found a lot of patients were getting treatment for the same problem that was treated earlier. He suggests a change in legislation could address those repeats to alleviate emergency department overcrowding.

“There might be an opportunity in the near future to give paramedics the decision to say, okay, this patient needs to go to the emergency department and this patient could be safely treated at home and referred to a primary care specialist,” Strum said.

Last week, the province’s health minister, Sylvia Jones, revealed that part one of a plan to stabilize health care includes expanding programs that help paramedics avoid taking patients to the ER on every call.

A pilot project that was launched in 2020 in more than 40 municipalities allowed paramedics to take patients somewhere other than an emergency room, such as a mental health facility, or to treat them on scene.

Initial results show patients accessed care 17 times quicker and 94 per cent didn’t go to the ER in the few days following care, Jones said.

“These successful innovative projects allow people, including palliative care patients and those experiencing mental health and addictions challenges, the option of receiving more appropriate care at home or in the community, avoiding a visit to the emergency department,” she said.

Hamilton joined the pilot project in April 2021 and allowed the jurisdiction to “treat and refer” 911 palliative care patients, opening the door to in-home care to ultimately reduce strain on the hospital system.

The province is also looking at potentially expanding when paramedics can safely and effectively provide treatment, starting with minor acute illnesses and injuries such as falls, and chronic conditions such as diabetes and epilepsy.

Jones said those 911 models of care are being expanded to more municipalities, but didn’t specify how many in her speech to the Association of Municipalities Ontario (AMO) conference in Ottawa last Wednesday.

Hamilton mayor Fred Eisenberger told Global News that the matter was discussed by big city leaders at the AMO meetings and confirmed it is something the province told him they are “working on.”

“I would hope that they would give paramedics the authority to make those decisions,” Eisenberger told 900 CHML’s Hamilton Today.

“There are a lot of people that come to the hospital thinking that if they call an ambulance they’ll get better, quicker service, when in fact, they don’t really need to go in by ambulance.”

 – With files from the Canadian Press