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Are You Ready for the Population Tsunami?

Are you ready for a significant increase in patient calls due to population growth and aging in your community? While you may have the capacity to cover the EMS demand in your service area today, will the same be true in 10, 20 or 30 years?

Bruce Moeller, PhD, principal of public safety consulting firm Juncture Group Inc., has served in a variety of roles as fire chief, city manager, county administrator and chief of staff for municipalities and agencies in Florida and Illinois. He now works with public services to determine their resource demands and how to plan for population-related projections in call volume.

Moeller presented "Fire-Based EMS: A Tsunami is Coming" Wednesday morning Feb. 20 during the EMS Today Conference and Exposition in National Harbor, MD. He began his talk by stating that while the fire services have been "immensely successful" in reducing risk of death and injury from fires, demand for medical services has spiked and will continue to rise, further stressing agencies that don't adequately prepare through increased staffing and resources.

“We have some severe challenges on the horizon," stated Moeller, adding that older Americans will outnumber youths in just 17 years, placing a "significant burden" on healthcare services to care for them. Medicare and Social Security are facing insolvency in the coming decades. Emergency department utilization and EMS transports are going up, further stressing EMS systems.

But how do you quantify this increased burden and state your case for more resources to elected officials?

Estimating the future EMS demand in your community involves four steps, according to Moeller:

  • Calculate your annual number of EMS calls by age based on the most recent 3–5 years of data, and create a table displaying your average number of annual incidents per age bracket;
  • Obtain the current and projected growth by age group in your service area (CDC, the Census Bureau, and local planning data are good sources of this information);
  • Calculate the current utilization rates by age group;
  • Apply current utilization rates to future and projected populations.

Once you have these numbers in hand, approach your elected officials and educate them on your findings. Stress that your plan is to adjust resources before they are needed. If you are currently meeting the needs of your community, demographic changes will mean that current resources will be inadequate, he said.

Moeller presented a case study of a fire-based EMS system responsible for providing paramedic-level services for a population of 250,000. Applying Moeller's algorithm, the community will see a 10% increase in EMS call volume by 2020, a 17% increase by 2030 and a 25% jump by 2030.

"Do you need another resource to handle 5000 more calls?" asked Moeller.

While fire services may not always be able to influence policymakers, they are the subject matter experts when it comes to resource utilization, Moeller concluded. Use data to make a reasoned, thoughtful case that what's working today will not be sustainable in the immediate and long-term future. "Elected officials do not want to see services degrade," he said. "That will make them nervous."

Finally, be persistent and realize that your initial efforts may not be successful. "You have to plant 'policy seeds,'" he said.

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