title: Higher energy prices are associated with diminished resources, performance and safety in Australian ambulance systems.
abstract: OBJECTIVE
  To evaluate the impact of changing energy prices on Australian ambulance systems.
  
  
  METHODS
  Generalised estimating equations were used to analyse contemporaneous and lagged relationships between changes in energy prices and ambulance system performance measures in all Australian State/Territory ambulance systems for the years 2000-2010. Measures included: expenditures per response; labour-to-total expenditure ratio; full-time equivalent employees (FTE) per 10,000 responses; average salary; median and 90th percentile response time; and injury compensation claims. Energy price data included State average diesel price, State average electricity price, and world crude oil price.
  
  
  RESULTS
  Changes in diesel prices were inversely associated with changes in salaries, and positively associated with changes in ambulance response times; changes in oil prices were also inversely associated with changes in salaries, as well with staffing levels and expenditures per ambulance response. Changes in electricity prices were positively associated with changes in expenditures per response and changes in salaries; they were also positively associated with changes in injury compensation claims per 100 FTE.
  
  
  CONCLUSIONS
  Changes in energy prices are associated with changes in Australian ambulance systems' resource, performance and safety characteristics in ways that could affect both patients and personnel. Further research is needed to explore the mechanisms of, and strategies for mitigating, these impacts. The impacts of energy prices on other aspects of the health system should also be investigated.
authors: School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Queensland. Lawrence.Brown@my.jcu.edu.au
authors: Lawrence H
authors: LH
authors: Brown
authors: Taha
authors: T
authors: Chaiechi
authors: Petra G
authors: PG
authors: Buettner
authors: Deon V
authors: DV
authors: Canyon
authors: J Mac
authors: JM
authors: Crawford
authors: Jenni
authors: J
authors: Judd
mesh_terms: D000552:Ambulances / Q000191:economics* / Q000706:statistics & numerical data; D001315:Australia; D003132:Commerce; D004632:Emergency Medical Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D006295:Health Resources / Q000191:economics*; D006297:Health Services Accessibility; D006801:Humans; D010578:Petroleum / Q000191:economics*; D012189:Retrospective Studies; D012449:Safety / Q000191:economics* / Q000706:statistics & numerical data; D014186:Transportation
chemical_list: D010578:Petroleum