Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jun 3;19(1):684.
doi: 10.1186/s12889-019-6964-1.

Social factors in frequent callers: a description of isolation, poverty and quality of life in those calling emergency medical services frequently

Gina Agarwal  1 , Janice Lee  2 , Brent McLeod  3 , Sabnam Mahmuda  4 , Michelle Howard  5 , Krista Cockrell  6 , Ricardo Angeles  7
Affiliations

Social factors in frequent callers: a description of isolation, poverty and quality of life in those calling emergency medical services frequently

Gina Agarwal et al. BMC Public Health. .

Abstract

Background: Frequent users of emergency medical services (EMS) comprise a disproportionate percentage of emergency department (ED) visits. EDs are becoming increasingly overwhelmed and a portion of use by frequent callers of EMS is potentially avoidable. Social factors contribute to frequent use however few studies have examined their prevalence. This study aims to describe social isolation/loneliness, poverty, and quality of life in a sample of frequent callers of EMS in the Hamilton region, a southern Ontario mid-sized Canadian city.

Study design: Cross-sectional quantitative study.

Methods: We surveyed people who called EMS five or more times within 12 months. A mailed self-administered survey with validated tools, and focused on four major measures: demographic information, social isolation, poverty, and quality of life.

Results: Sixty-seven frequent EMS callers revealed that 37-49% were lonely, 14% had gone hungry in the preceding month, and 43% had difficulties making ends meet at the end of the month. For quality of life, 78% had mobility problems, 55% had difficulty with self-care, 78% had difficulty with usual activities, 87% experienced pain/discomfort, and 67% had anxiety/depression. Overall quality adjusted life years value was 0.53 on a scale of 0 to 1. The response rate was 41.1%.

Conclusions: Loneliness in our participants was more common than Hamilton and Canadian rates. Frequent EMS callers had higher rates of poverty and food insecurity than average Ontario citizens, which may also act as a barrier to accessing preventative health services. Lower quality of life may indicate chronic illness, and users who cannot access ambulatory care services consistently may call EMS more frequently. Frequent callers of EMS had high rates of social loneliness and poverty, and low quality of life, indicating a need for health service optimization for this vulnerable population.

Keywords: Emergency medical services; Frequent callers; Health services; Poverty; Quality of life; Social factors; Social isolation.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram for participants
See this image and copyright information in PMC

References

    1. Lowthian JA, Curtis AJ, Cameron PA, Stoelwinder JU, Cooke MW, McNeil JJ. Systematic review of trends in emergency department attendances: an Australian perspective. Emerg Med J. 2011;28:373–377. doi: 10.1136/emj.2010.099226. - DOI - PubMed
    1. Office of the Auditor General of Ontario. Annual Report: Land Ambulance Services Section 404. http://www.auditor.on.ca/en/content/annualreports/arreports/en15/4.04en1....
    1. Hunt KA, Weber EJ, Showstack JA, Colby DC, Callaham ML. Characteristics of frequent users of emergency departments. Ann Emerg Med. 2006;48:1–8. doi: 10.1016/j.annemergmed.2005.12.030. - DOI - PubMed
    1. Hall MK, Raven MC, Hall J, Yeh C, Allen E, Rodriguez RM, et al. EMS-STARS: Emergency Medical Services “Superuser” Transport Associations: An Adult Retrospective Study. Prehosp Emerg Care. 2015;19:61–67. doi: 10.3109/10903127.2014.936630. - DOI - PubMed
    1. Scott J, Strickland AP, Warner K, Dawson P. Frequent callers to and users of emergency medical systems: a systematic review. Emerg Med J. 2014;31:684–691. doi: 10.1136/emermed-2013-202545. - DOI - PubMed

MeSH terms