Across the USA, the 911 utilization rate has been increasing. Unfortunately, resources haven’t grown at the rate needed to meet the demand. There was a time when people thought 911 was rarely called, an ambulance tires remained mostly unworn. Those days are long gone.
The rise in 911 calls (combined with staffing shortages) has left EMS, fire, and police scrambling for answers. This article highlights three reasons your 911 utilization rate is high and provides steps to fix it. In addition, we’ll discuss super-utilizers, chronic diseases, and underserved populations.
Why are 911 utilization rates rising? How do we answer the increase in calls? Let’s talk about the issue and discuss solutions.
Analyze: Why are 911 Calls Up?
911 utilization rates have been rising for a while. There may be specific reasons your 911 rates have risen, or it may be part of a more significant trend of calling 911 for non-emergencies. To fix the problem, we need to uncover the reasons for the increase in 911 calls.
First, look at the people calling 911. Are they from a similar area? Is there a single patient that’s doing most of the calling? Is there a change in the healthcare infrastructure or laws creating this issue?
Before we get into some of the most common reasons for 911 calls, take a moment to pinpoint why 911 calls are rising in your area. Healthcare and public safety has unique needs that require a nuanced approach. While there are undoubtedly universal pain points in EMS and healthcare, going forward without looking at your program would be unwise.
Here are a few things to do:
- What does your staff say? The people on the ground will know the problem points and where most calls originate. Ask their opinion on rising 911 calls. You’ll get some ground-level insight, and the team will be grateful to be involved.
- What are the patients saying? If you can, ask patients about changes they’ve seen and felt in the area. For example, there might be some change in insurance providers or perhaps a new environmental or infrastructural change that has caused turmoil. Regardless, seeking the patient’s opinion will provide valuable insight.
- Finally, look at the demographics and geography. Is there a specific place where the 911 calls are increasing? What is unique about that area? The pandemic was an obvious change, but sometimes there are more subtle diseases spreading.
These questions should offer a starting point to uncover a rise in call volume. Once you know the cause, you can start working on solutions.
3 Common Reasons for an Increase in 911 Calls
911 calls rise steadily in some areas and rapidly in others. It comes down to an aging population, with many dealing with more chronic conditions. However, it might also result from increased drug use or a rise in mental health emergencies.
Sometimes, the local hospital or physicians have become overloaded, or there has been another significant change to public health. These changes can disrupt any semblance of equilibrium healthcare, driving more people to call 911. In these cases, some patients who might have driven nearby in the past now want an ambulance to transport them to an out-of-county clinic.
It could be all these reasons, but let’s talk about three of the most common:
- Super-utilizers (frequently recurring patients)
- Chronic disease/lack of primary care
- Homelessness, Substance abuse, or Mental Health Struggles
Let’s look at each of these in more depth, then talk about ways you might combat the issues.
Super-Utilizers and the Rising 911 Utilization Rate
As any EMS manager knows, a small portion of the population often makes up the majority of local 911 calls. There have been instances where a single patient has called 911 hundreds of times over a relatively short period.
Super-utilizers form a relatively complex health picture. Some might call the ambulance so much that it’s impossible to blame the issue solely on a lack of primary care. However, there is likely a deficiency in their needs. These patients, though they often call for minor reasons, strain the 911 systems – particularly those areas without the resources for a tiered response.
Sometimes, there might be little you can do to curb this behavior. For example, the patient wants to continue calling 911 and being transported to the ER, and they don’t want anything else. However, often, if the patient can go to an alternative destination that provides a better experience, they will choose the alternative.
A good alternative is a coordinated response from a mobile integrated healthcare model. How does this work? A healthcare team will go to these patients and attempt to uncover the root of the frequent calls. After that, they make a plan to address the patient’s health needs – this could mean regular visits, transport to alternative destinations, or reconnecting the patient with primary care.
You can read our article covering models to reduce 911 calls if you want more information.
Lack of Primary Care: Chronic Diseases and Rising 911 Calls
Some chronic diseases don’t seem to let up. And, when patients live alone or don’t have a healthy lifestyle, they are likely to call 911 more. Many EMS organizations choose to throw up their hands and “deal with it,” however, others have taken a more innovative, proactive approach – many with excellent results.
What have they done? Many have instituted mobile integrated healthcare. These programs seek to contact the patient with their physician in the out-of-hospital environment. Many times, these interactions are facilitated with a video call. A community paramedic assists with the assessment and acts as a go-between for the patient and the physician.
These interactions are almost universally positive, making the patient feel comfortable and safe in their own home and reducing their need to call 911 frequently. Also, with a provider actively checking on them (often weekly or monthly), it’s easier to manage their medication schedule and ensure they are following any recent hospital discharge instructions.
Overall, this method leads to healthier, happier patients who are less likely to call 911 for all their needs. If you’re curious to see some numbers, you can look at this report from the Colorado Springs cares program.
Underserved Populations: Homeless, Substance Abuse, Mental Health
Unfortunately, groups of patients are often swept under the rug. Mobile integrated healthcare and community paramedicine seek to provide care to all patients – no matter their situation. Among these groups are those with substance abuse struggles, mental health issues, and homelessness.
These patients often have little social protection, and when their health begins to fail, they rely on EMS, fire, and PD – increasing the 911 utilization rate. However, instead of a constant police or ambulance response, it’s much more efficient to have a mobile health team that understands the problem, as they will be in the best situation to provide a long-term fix, not just a temporary band-aid.
Many areas have specific task forces that address drug use, including post overdose response. These teams specifically reach out to overdose patients, offering them help if they want it. To reduce 911 calls, there must be dedicated programs that can deliver teams of professionals to address the needs of these populations.
Here’s a brief overview of these programs:
- Mental health response. Most agree that a more coordinated response to mental health patients is vital. In many areas, police officers are the default responders to mental health calls. Mobile integrated healthcare teams can effectively respond to these patients, addressing the root cause and reducing frequent 911 calls.
- Substance abuse. There are numerous programs that an MIH team can initiate to address substance abuse. Some areas have succeeded with harm reduction programs, while others use a dedicated overdose response team. These teams can ensure the patient has every chance to avoid a recurring overdose.
- Homelessness. Homelessness places people in vulnerable positions – particularly when it comes to their healthcare. What many people don’t realize is that the homeless population’s health can affect the entire city’s health. If an unchecked disease spreads through those without a home, these diseases will inevitably affect the whole population. This has been evident during COVID, with many areas actively providing testing and vaccination to the homeless.
Read our article on MIH-CPs impact on the homeless population – this guide will give you more specifics.
Final Words on Reducing 911 Utilization Rate
The increase in 911 calls in your area is likely a compound of many issues. After you uncover the root of the uptick in calls, you’ll be in the best position to address it.
It could be chronic diseases, overdoses, or mental health struggles. All these issues can be efficiently addressed with community paramedicine and mobile integrated healthcare. For more information on initiating these systems, see our article on starting community paramedic programs.
Also, contact Julota to see how they connect mobile integrated health teams with other community members. Their interoperable software will make your team more robust and more effective at reducing 911 calls.