title: Disturbing trends: the epidemiology of pediatric emergency medical services use.
abstract: OBJECTIVE
  To compare pediatric ambulance patients transported for chief complaints of suicide, assault, alcohol, and drug intoxication (SAAD) with pediatric patients transported for all other chief complaints.
  
  
  METHODS
  An out-of-hospital database for the primary transporting service in an urban area was analyzed for patients 0-20 years of age from 1992 to 1995. Chief complaints by age, gender, and billing status were analyzed.
  
  
  RESULTS
  There were 17,722 transports. The SAAD group comprised 14.9% of all transports (suicide attempt 1.6%, assault 5.9%, alcohol intoxication 3.2%, and drug abuse 4.2%). The proportion of transports due to SAAD increased with age: 0-11-year-olds (4.2%); 11-16-year-olds (17.5%); and 17-20-year-olds (20.3%) (p = 0.0001). Genders were equally represented in the overall group, while males comprised 52.6% of the SAAD transports (p = 0.032). In the SAAD group, the majority of transports for assaults (55.9%) and alcohol (58.8%) involved males, while females were the majority in transports for suicide (52.3%) and drug abuse (66%) (p = 0.0001). Reimbursement sources differed, with those in the SAAD group less likely to be reimbursed by private or public (Medicaid, government) insurance (p < 0.0001) compared with the overall group.
  
  
  CONCLUSIONS
  A substantial proportion of pediatric emergency medical services transports are for high-risk conditions. This patient population differs from the overall group by age distribution and reimbursement source.
authors: Department of Emergency Medicine, University of New Mexico School of Medicine, Albuquerque 87131-5246, USA.
authors: R E
authors: RE
authors: Sapien
authors: L
authors: L
authors: Fullerton
authors: L M
authors: LM
authors: Olson
authors: K J
authors: KJ
authors: Broxterman
authors: D P
authors: DP
authors: Sklar
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000437:Alcoholism / Q000453:epidemiology; D000552:Ambulances / Q000191:economics / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009516:New Mexico / Q000453:epidemiology; D010372:Pediatrics / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D012189:Retrospective Studies; D017678:Sex Distribution; D013406:Suicide, Attempted; D014947:Wounds and Injuries / Q000453:epidemiology