
911 calls from chronically ill drop after Milwaukee community initiative - SQL2219
https://www.jsonline.com/story/news/2018/04/13/911-calls-chronically-ill-drop-after-milwaukee-launches-community-paramedic-initiative/511123002/?from=new-cookie
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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

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

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CamTin
You're correct, of course. Updated and fixed.

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

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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...

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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.

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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.

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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.

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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.

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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."

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s17n
It's almost like having people be responsible for their own healthcare doesn't
actually work in the real world.

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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.

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John_KZ
I don't know which country you live in but I've talked to paramedics about
this issue, and it's extremely rare (at least in my country). Once in a blue
moon, an old woman living in isolation in a village or something will call an
ambulance just to get in town. In that case, she could only do this once
because the issue got talked about.

Nobody has infinite access because the access is limited by human
intervention. It's limited based on need, not available cash.

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orf
Why is the fire department launching paramedic initiatives?

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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.

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isostatic
Most communities? The only place I've heard of it is the US.

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Spooky23
Its common in the US for basic life support to be delivered by private or
hospital ambulances, or municipal EMS services by cheap EMTs. Sometimes they
are just drivers. Usually advanced life support is done by paramedics or
others who work for municipal EMS or fire departments.

Bigger paid departments have a split between engine companies and rescue
companies. Rescue companies have fancy tools for all sorts of situations and
usually have more trained medical capability. That’s why you’ll see ladder
trucks dispatched to medical emergencies in the US.

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

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rosstex
What shall we call it?

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ModernMech
Colloquially known as the 80/20 rule, although those percentages aren't fixed,
but it's the same idea.

