‘Hurry! It’s an emergency’
: Emergency Ambulance Workload: A study of variation in ambulance utilisation between geographical areas in the East of England.

  • John Martin

Student thesis: Doctoral ThesisDoctor of Health (DHealth)


With an increasing use of health services in England there is a political desire to alter demand patterns and re-design services to reduce spend. With a yearly 4% increase in ambulance service use a variety of generic health education initiatives have been tried to reduce demand with seemingly limited effect. Calling an ambulance when you have a perceived need can be considered a health behaviour and to effectively intervene to alter this behaviour requires an understanding of variation in population use. This study analysed 769,376 emergency calls in the East of England including those not conveyed to hospital by three acuity levels. Population use of the ambulance service was considered in relation to sociodemographic factors derived from the census. A significant regression was found (F(27,3582)=44.81, p<0.001), with an adjusted R² of 0.2469. Population factors related to higher utilisation included age groups 85-90 and 90 & over, mixed and black ethnicity, and those who had never worked or were long-term unemployed. The study examined, using moderated regression analysis, the influence of self efficacy, access to services, general health status and social networks on the relationship between socio-demographics and ambulance utilisation. The findings suggest that access to services and general health status of the population act as significant moderators, but self efficacy and social networks are not significant moderators. Policy interventions suggested involve targeting specific population types related to higher utilisation to manage demand. The original contribution of this study is the further development of understanding ambulance utilisation through the use of large datasets within the English NHS context.
Date of Award1 May 2019
Original languageEnglish
Awarding Institution
  • University of Bath
SupervisorAlan Buckingham (Supervisor)


  • Ambulance
  • Utilisation
  • Health Belief
  • Population
  • Emergency
  • Demand

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