Date of Conferral

2020

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

Miriam Ross

Abstract

Ambulances regularly respond to scenes and transport patients while using lights and sirens (L&S), which are associated with an increased risk of vehicle crashes. The use of L&S persists, despite the risks, which impact emergency medical service (EMS) workers, patients, and other drivers and pedestrians on U.S. roadways. To understand the factors associated with ambulance crashes while using L&S, this study applied the Donabedian model to the problem. The purpose of this study was to investigate the association between 3 organizational structural factors—organizational type, organizational status (staffing model), and level of service—and ambulance crash rates while using L&S. This study used a quantitative, correlational, cross-sectional design with a sample drawn from the National EMS Information System data set to examine the relationship between these factors and ambulance crashes while using L&S. After application of inclusion criteria, a sample of 4,951,063 cases was drawn and analyzed using X2 test of association and multiple logistic regression. There was a statistically significant association between level of service and ambulance crashes while using L&S, using the X2 test of association with a small effect. There was no statistically significant relationship found between the other variables using X2 tests or the logistic model. The organizational structural factors examined in this study failed to explain most of the variance in ambulance crash rates. EMS healthcare administrators and researchers should continue to explore potential modifiable factors to reduce the incidence of these events and promote positive social change by reducing the risk of injury to patients, EMS workers, and the public at large.

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