Association between long-term care setting and emergency transportation utilisation

Abstract Background The burden on healthcare systems from the utilisation of emergency transportation (ET) is increasing worldwide. Particularly care-dependent individuals and long-term care recipients are affected. Objective We aim to investigate the factors contributing to ET utilisation, particularly in these care-related groups and settings. Methods Using claims data on ET utilisation in conjunction with long-term care (LTC) insurance data, we identified 561,322 ET events from 2018–2022 in insured individuals of AOK Saxony-Anhalt, Germany. Age-standardised incidence rates (ASIR) were calculated with the duration of insurance as time at risk. Negative binomial regression assessed factors influencing ET utilisation. Results ET utilisation remained stable over 5 years, with an ASIR of 112.59 per 1000 insured person–years. High care dependency level correlates with higher ET rates, both in terms of IR and in the regression model. This correlation strengthens when combined with LTC settings involving formal caregivers, such as nursing homes and formal home care. Multimorbidity is suggested as a potential contributing factor, particularly for individuals with care levels 4 and 5, but did not fully explain the observed patterns. Conclusion Care dependency and professional care are strongly associated with increased ET utilisation. The findings suggest a need for structural improvements in LTC, clearer legal frameworks, and better competencies across all care providers, including enhanced training and education, to address unmet needs and reduce potentially avoidable ET events. Further research should explore these relationships in more depth to inform interventions aimed at relieving pressure on emergency services.