911 calls from chronically ill drop after Milwaukee community initiative

[CamTin]

It is more honest to keep the comparison either between absolute numbers or percentages:

7% of emergency calls made by 0.16% of people

4,288 of 62,763 emergency calls made by 100 people

[cma]

Does it include things like head of a shopping mall calling for emergencies with customers?

[jws]

I think you might have a decimal off. 100/62763 = .0016 = 0.16%

[teeray]

To further illustrate: On average that's about 44 calls per person, or a 911 call made by one of those 100 people every week or sometimes two, given that these numbers were over the course of a year.

[Hupriene]

Since the population of Milwaukee is around 600k, that should be 0.016% of people.

Or you should say something like 'of people who made emergency calls'

edit: that second one is still problematic since we only a couple data points on the distribution of calls per capita.

[proto-n]

How did you get 1.6%?

[wheelerwj]

its not more or less dishonest, they are the exact same numbers

[chias]

"[In 2015,] 7% of the 62,763 emergency calls [in Milwaukee] came from the same 100 people"

[doctorsher]

Thank you for this. The title oversells its scope/importance by a fair margin. I hope it is unintentional and not a purposeful tactic...

[rdtsc]

A coworker was volunteering with the local rescue squad. They knew the frequent callers personally. One was a particularly sad story of lonely old woman who would call because she just wanted a ride to the hospital and it seemed to be her only source of human interaction. They could never say "we are not coming, it's so and so" because well that one time she could have really needed help. Some insurance companies have incentives against this by charging a steep price for the ambulance ride and only waving if person is admitted. But at a deeper level this is a failure of social services and increased isolation and loneliness experienced by the elderly. We usually hear about how it happens in Japan, but it's happening here in US as well.

[ericsilver]

Their success metric may just be reversion to the mean; since they started by selecting the people who had made the most calls, you would expect the number of calls to come from those specific people to fall in the coming years. Since there was also likely some underlying health condition, you would expect the between-year variance to be large. It might well be that their program has no effect whatsoever.

[dwaltrip]

If no other group is calling at a similar level, then it's not reversion to the mean. The mean has actually been shifted downwards.

> Since there was also likely some underlying health condition, you would expect the between-year variance to be large. It might well be that their program has no effect whatsoever.

The rate dropped significantly each year from 2015 through 2017 -- 3 years in row. It's possible this is pure chance, but it seems rather unlikely.

[bunderbunder]

If they're really tracking the same 100 identified people, with no replacement, then you'd expect the same result even without regression to the mean, simply because very sick people tend to die, and dead people tend not to call 911.

One would hope that they're not doing that, and it's just that the article is imperfectly worded.

[narrator]

The system by which people have to spend 8 years in school to become doctors and the limited amount of spots in medical schools is one of the main impediments to lower health care costs since doctor salaries are astronomical compared to other countries. This program is a good first step for making health care more affordable in that it is empowering paramedics.

[analog31]

A friend of mine, who's a former EMT, once told me: "When you're an EMT, you get to know all of the diabetics in your area."

[s17n]

It's almost like having people be responsible for their own healthcare doesn't actually work in the real world.

[always_good]

Well, it's having people with infinite access to shared, finite resources.

I worked as an EMT and would regularly get bizarre calls from people abusing the system to take their kid to the hospital because he hurt his arm, the parents following in tow by car. Or a domestic dispute where they think it's reasonable to call an ambulance like it's a less-serious police dispatch to handle more minor issues. Or really just a free taxi service in general. -- You don't have to pay if you just walk out of the hospital or ignore the collections. If you don't have insurance, it's pretty much the only option.

I'm not sure if there are any alternative medical models that solve the nature of some people to abuse shared resources.

[fydorm]

How is that relevant?

[orf]

Why is the fire department launching paramedic initiatives?

[repiret]

If you want a reasonable response time from the fire department, then you end up with way more firefighters on duty at any given time than there are fires to respond to.

Instead of paying them to twiddle their thumbs, most communities train them as paramedics and either have the fire department run an ambulance service or just use them as first responders who can get to a medical scene before an ambulance can.

[maxander]

Aside from the other answers; because "being on-call 24/7 and having the ability to safely drive through town at high speed" is a capability just as important as paramedical training, for that role, and who else has it?

[qmarchi]

Most paramedics are branches off of the local fire department.

[dmckeon]

In the US, fire departments have far fewer fires to respond to, and many more medical calls, varying with the local situation - dual or single response by FD and EMS, transport by EMS xor FD, FD has paramedics (many hundreds of hours of training) or only EMTs (about 100 hours) or variations in between (varies by state).

[aantix]

This sort of distribution plays out everywhere. The rich. Three point shooting. Now, 911 calls.

[rosstex]

What shall we call it?