The affordable care act and ambulance response times

Abstract

and Policy Studies Seminar Series for their helpful comments and suggestions. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research. NBER working papers are circulated for discussion and comment purposes. They have not been peer-reviewed or been subject to the review by the NBER Board of Directors that accompanies official NBER publications.

Association of Affordable Care Act Implementation With Ambulance Utilization for Asthma Emergencies in New York City, 2008-2018

“…In contrast to our results, 2 previous studies by Courtemanche et al reported that ACA implementation was associated with increased EMS dispatches within the NYC EMS system. The first showed that ambulance dispatches for minor injuries increased following implementation of the ACA, and the second described an overall increase in all calls of relatively lower severity over the same time period . The authors attributed these trends to insurance expansion on the grounds that health insurance insulated patients from the costs of utilizing EMS .…”

“…The first showed that ambulance dispatches for minor injuries increased following implementation of the ACA, 10 and the second described an overall increase in all calls of relatively lower severity over the same time period. 2 The authors attributed these trends to insurance expansion on the grounds that health insurance insulated patients from the costs of utilizing EMS. 10 Unlike asthma, minor injuries are not sensitive to ambulatory care, so increased access to primary care services would not have had an effect on the incidence of minor emergencies.…”

“…Most EMS systems have fixed resources, including a limited number of personnel and ambulances. A strain on these systems because of increased utilization or other factors can result in delayed care and even increased mortality for patients with serious emergencies . For this reason, changes in EMS utilization, such as those triggered by health insurance changes, could have important implications for EMS systems.…”

Did UberX reduce ambulance volume?

“…Cities have noticed enough residents making this shift that they have discussed how these ride‐sharing services could be integrated into their EMS frameworks. Furthermore, the introduction of the Affordable Care Act has slowed ambulance response times by 19% (Courtemanche, Friedson, Koller, & Rees, ), exacerbating the need for a partial substitute to traditional ambulances.…”

How important are delays in treatment for health outcomes? The case of ambulance response time and cardiovascular events

“…5 Further understanding the effect of RT on health will also facilitate more efficient healthcare policies. An example is the improvement in access to ambulance services as a result of the Affordable Care Act in the US, which resulted in a 19% increase in wait times due to the increased strain on the system (Courtemanche et al, 2019).…”