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Each year, millions of Americans call 911 for time-sensitive issues that don't require Emergency Medical Services (EMS). In need of medical help, these callers may treat 911 as an entry point into the healthcare system, yet an ambulance to the emergency department can harm both their own long-term health and the health of others. In a field experiment in Washington, DC, the investigators randomly assign nurses directly into 911 calls in order to triage low-acuity calls. While other 911 reforms have denied callers access to alternative resources, this effort reforms 911 by offering appropriate care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Triage Nurse | Experimental | Triage nurse |
|
| No Triage Nurse | Active Comparator | No triage nurse |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Triage nurse | Behavioral | Triage nurse joins 911 call |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Ambulance dispatch | Ambulance is dispatched in response to the 911 call | During or immediately subsequent to call |
| Ambulance transport | Caller is transported in dispatched ambulance | During or immediately subsequent to call |
| ED visit, 24 hours | Emergency department visit within 24 hours | 24 hours |
| ED visit, 6 months | Emergency department visit with 6 months | 6 months |
| Primary care visit, 24 hours | Primary care visit within 24 hours | 24 hours |
| Primary care visit, 6 months | Primary care visit within 6 months | 6 months |
| 911 use, 24 hours | Whether caller made subsequent calls to 911 within 24 hours | 24 hours |
| 911 use, 6 months | Whether caller made subsequent calls to 911 within 6 months | 6 months |
| Health expenditures |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Office of Unified Communications | Washington D.C. | District of Columbia | 20032 | United States |
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| Label | URL |
|---|---|
| Pre-Analysis Plan | View source |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Feb 13, 2025 | |
| Reset | Mar 5, 2025 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Feb 13, 2025 | Mar 5, 2025 |
| ID | Term |
|---|---|
| D004630 | Emergencies |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| No triage nurse |
| Behavioral |
Triage nurse does not join 911 call (business as usual) |
|
Total dollars and log-transformed dollars of Medicaid health expenditures
| 6 months |