Health systems around the world face the same critical challenge: how to ensure that people have full access to health care while continuously improving the quality of care and avoiding rising costs. Accidents, poisonings, acute diseases, and injuries are known to contribute significantly to negative trends in population dynamics and overall health. For this reason, there is an urgent need to maintain and improve the work of the Emergency Medical Service (EMS) as a factor of national security. As part of this research, a market study of the New York City emergency services market is being conducted through the lens of competition and improvement of internal processes.
Revision of the Ambulance Concept
The concept of emergency medical care in the United States, and New York City in particular, has been continually changing throughout the development of the health care system. It is essential to understand that emergency medical teams were initially designed for the sole purpose of transporting a victim from the scene of an emergency to the nearest treatment center as quickly as possible. Thus, the ambulance was not previously equipped with necessary tools to provide care on-site and only had a transport function. However, in the second half of the last century, the situation changed radically through the reorganization of the health care system in the United States. Emergency medical personnel were given more authority to ensure safety for the victim. Such modifications occurred at all levels: they affected not only government brigades but also private relief services. Since then, the ambulance team has made its own decisions about its actions. If necessary, it is required to provide the victim with treatment and to conduct non-resurgence operations.
New York Emergency Service System
New York City’s emergency medical system includes several different areas, comprising private emergency services and municipal emergency services. There is an essential difference between the New York City emergency system and the activities of other countries’ crews. For example, while in European countries, the ambulance system seeks to provide highly qualified assistance on the spot, the U.S. system is more of a transport mission. Despite this, modern private medical aid vehicles are equipped with life support systems, and teams usually have a qualified paramedic (Richmond County Ambulance Services, 2020).
The analysis of the market situation around the ambulance in New York should consider the economic side of the issue. It is essential to understand that ambulance services are too expensive for most New Yorkers, who only call an ambulance in the most extreme cases (Kliff, 2019). Thus, according to Kliff (2019), the cost of an emergency call to treat a small scratch on the arm may exceed $600. In this case, part of the amount can be covered by the insurance program. Most Americans, especially in low-income areas of New York City, prefer to ignore private services and instead choose a private car to get to a clinic (Corrado et al., 2017). There are special programs for older Americans, and great discounts are available for them. It should be borne in mind that the further development of the New York emergency market may be in question if the cost of services remains the same.
The Demographic Situation in New York
While researching the New York City emergency market, one cannot help but analyze its demographics. New York City is the most populous city in the United States, with over 8.4 million people by 2019 (World Population Review, 2020). Its population density per square mile is about 28 million people. However, demographers predict that the population of cities will continue to grow (World Population Review, 2020). The City of New York consists of five large districts, the most populous of which is Brooklyn. It is here that the majority of its residents is concentrated, which means the most significant interest in emergency medical services. For a person in need of emergency care, it usually makes no difference whether to go to a private or public service. To call for help, one needs to dial 911, and the dispatcher will decide which service is closest to the person and will be able to meet their needs depending on the situation (Doyle, Graves, & Gruber, 2019). All of the above leads to the conclusion that one of the most densely populated cities needs an efficient emergency system and market trends should be identified to optimize it. Optimization of the ambulance system will become one of the priorities in the health care development strategy.
Market Analysis of Emergency Services in New York
A critical mission of the modern medical services market relates to a competitive function, expressed in professional and socio-economic market competition of medical organizations for achieving high results in diagnosis, treatment, rehabilitation of patients, and in the service to patients in conditions of high demand. Due to the increased density of population, the city market is replete with offers of paid medical ambulance services. Most of these organizations are part of the EMS system, which means they can provide emergency care, not just transportation of the victim (Richmond County Ambulance Services, 2020).
Private companies contract with the municipality to have access to emergency calls from residents. Paid services within New York City have a number of advantages, including a greater variety of market offers, different pricing policies, and more advanced tools. Private companies should be interested in new customers who may need to make an emergency call, in which case the service can offer faster machines to reduce travel time to the clinic. Moreover, due to the abundance of the private sector in emergency services, companies have to reduce the cost of services while maintaining their quality. This effect has a positive impact on the reputation of private companies as they may sometimes cost less than municipal services. This creates a competitive situation since a public service needs to remain relevant among the population.
Free competition in the market of emergency medical services is achieved under two necessary conditions: almost every medical organization provides the service and there are a large number of manufacturers of medical services on a particular territory. In order to maintain their efficiency, New York City services may look towards lowering tariffs for their services and expanding their car fleet. For example, services may include private health insurance policies that are currently virtually out of service in urban clinics (Kliff, 2019). These trends will trigger a response from private companies, as they struggle to be the most advantageous and competitive service. Specific recommendations offered to private companies, in order not to lose their relevance among clients, include:
- controlling changes and reforms in public services;
- lowering tariffs for services provided;
- inclusion of work with health insurance;
- simplify patient transportation and reduce travel time;
- equipping cars with an extended set of medical instruments;
Training paramedics in skills that are standard only available at treatment centers – this will increase the chances of survival for New Yorkers. All of the above steps contribute to strengthening the role of private ambulance teams in the emergency medical services market. Healthy competition leads to lower cost of medical services and improved quality and efficiency.
Corrado, M. M., Shi, J., Wheeler, K. K., Peng, J., Kenney, B., Johnson, S., & Xiang, H. (2017). Emergency medical services (EMS) versus non-EMS transport among injured children in the United States. The American Journal of Emergency Medicine, 35(3), 475-478.
Doyle, J., Graves, J., & Gruber, J. (2019). Evaluating measures of hospital quality: Evidence from ambulance referral patterns. Review of Economics and Statistics, 101(5), 841-852.
Kliff, S. (2019). Surprise medical bills, the high cost of emergency department care, and the effects on patients. JAMA internal medicine, 179(11), 1457-1458.
Richmond County Ambulance Services. (2020). RCA Ambulance services. Web.
World Population Review. (2020). New York City, New York population 2020. Web.