The Impact of 911 Systems and Hospital Choice on Ambulance Response Times and
Mortality: The Case of Cardiac Arrest
We now turn to an analysis of individual cardiac incidents. We evaluate the effects of the 911 infrastructure on patient outcomes, as well as on several “intermediate inputs” to patient outcomes, in particular, several components of response time. We focus on intermediate inputs for several reasons. First, since 911 provides service benefits through an investment in information technology, we are inherently interested in disentangling the extent to which 911 provides services which are more timely and better respond to patient characteristics. Second, mortality is a very noisy measure of the productivity of the emergency response system, and even in our large dataset, we see only a few thousand deaths from cardiac incidents, and only a few hundred in the counties without Е9П systems. Third, even in these cases, we expect that the policy variables will have a significant impact on outcomes in only a small subset of the cases. Many of the patients who die, would die regardless of the response time; and many patients who survive did not rely heavily on the emergency response system. However, if we establish that 911 reduces response time, we can rely on a number of clinical studies which provide direct evidence about the benefits of faster response times for mortality. Electronic Payday Loans Online
Building on our analysis from Section П, we predict that the first component of response time, TTME_TO_SCENE, should be lower when counties are able to gather address and location information more rapidly and precisely, and when ambulance resources are allocated efficiently (recall cardiac emergencies are high priority events). The second component, called TIME_AT_SCENE, should be longer when more treatment is given prior to moving a patient; it should also be longer when patients are located in high-rise buildings or large complexes. The final component, TIME_TO_HOSP, should be lower when dispatchers are able to provide better assistance to ambulance drivers in terms of routing and directions to hospitals from varied locations. On the other hand, TIME_TO_HOSP should reflect a tradeoff between the benefits of arriving at a high-quality hospital and the benefits of receiving hospital attention as soon as possible. The impact of 911 on this tradeoff might be to encourage ambulances to take somewhat longer rides, if time has been saved in other parts of the process.