BALTIMORE -- The repeat callers to Baltimore's 911 ambulance dispatch system are a chronic problem in search of a solution. And the city's health commissioner may have come up with one. As far as pilot projects go, Dr. Joshua M. Sharfstein's proposal to enlist a health care advocacy group to assess the medical needs of these repeat callers and get them help through traditional means falls into the category of, "Why didn't anyone think of this sooner?" It offers the possibility of resolving the problem to the benefit of both the system and individuals in need of care.
Last year, the city's 911-generated ambulance calls totaled about 150,000, with about 2,000 requests coming from the same 91 people, according to a review by the city. It doesn't take a health care policy expert to figure out that some of these callers, for whatever reason, are relying on the Fire Department's public emergency crews as quick access to health care. That shouldn't be the case even in the worst circumstances, but with the number of uninsured increasing, it's easy to see how it could happen time and again.
Now, staffers at Baltimore Healthcare Access will try to identify the 91 repeat callers, determine their health care needs and get them the appropriate care. If the callers have medical insurance, Healthcare Access staff will act as go-betweens. If some are eligible for Medicaid and Medicare, the staff will try and enroll them to cover the costs. Healthcare Access has experience in this area; it administers the successful state program that links poor, uninsured children to health care benefits. The organization also does outreach with drug addicts, the homeless and other medically fragile people who need assistance.
Reducing the number of repeat callers would ensure that city emergency medical crews are being used for the right reasons. The cost to the city of sending out an ambulance crew that provides basic care and transport averages about $350, and that estimate is dated.
If this experiment works, the cure will be real for the ambulance squads and for the ailing callers.