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Evaluating emergency medical services: controlling the rising cost of saving lives.

A combination of recent changes in the way Emergency Medical Services are reimbursed by Medicare for ambulance services and escalating costs have prompted many EMS providers to seek new ways to meet the needs of the communities they serve in a more cost-effective manner. This article reports one such study of a county in the Southeastern United States with a population of over 100,000 distributed over an area of 600 square miles. The study used industrial techniques, including a combination of historical data analysis and time studies, to recommend ways to cut costs without adversely affecting either the emergency coverage or patient case provided. Based on usage data, reducing the number of service units during time of least demand was suggested. The time studies indicated that it might be possible to combine some jobs (e.g. billing personnel and dispatchers), The usage data also showed that the existing geographical distribution of the units matched demand. The study demonstrated that industrial engineering techniques can be usefully employed in the evaluation of the efficiency and effectiveness of public services.