ECONOMIC ANALYSIS OF CURRENT AND FUTURE NEEDS FOR EMERGENCY MEDICAL SERVICE SYSTEMS IN THE STATE OF OKLAHOMA

Scope of Study. This dissertation develops analytical tools that can be used by emergency medical service (EMS) system planners and decisionmakers in their attempt to provide efficient, effective and equitable EMS systems to the public. Four interrelated models are developed. First a population projection model is used to determine the expected number of current and future EMS calls. Secondly, optimal location for EMS facilities are determined using a special algorithm known as Generalized Location Optimization Selection System (GLOSS) which is based on the generalized transportation procedure. The objective for this problem is set up to minimize total cost subject to some constraints. The third procedure involves a cost-revenue analysis for alternative EMS systems. Finally, a probability model is introduced to analyze and determine the probability an EMS system will be adequate to meet most emergencies. Since the nature of problems in EMS systems can vary, special effort is made to address problems that are faced at the county, multi-county and state levels. In addition, an analysis of first responder system, basic life support system and advanced life support system is included at the county and multi-county level.; Findings and Conclusions. Specific results of the study include projected number of EMS calls at local, regional and state level; optimal location strategies for first responder systems, basic life support systems and advance life support systems at local and regional level; and location strategy for state level basic life support system. Other results of the optimum location strategy include estimates of the lowest maximum distance and the lowest average distance an ambulance should travel to an emergency spot. The budget analysis demonstrated estimation procedure of costs and revenues of alternative EMS systems. The results of the probability model showed that EMS systems in the rural areas have very low intensity of usage of ambulances meaning there is a high percentage of idle time. This implies that decisionmakers must always weigh the trade-off between allocating additional funds and the benefits received from these funds. Hence, arrangements for sharing of services among counties and communities can improve efficiency and effectiveness of the service.