Presentation (CTI)

OBJECTIVES: Suicidal behaviour is a major public health issue, often requiring attendance by first responders such as paramedics and police. No studies have estimated first responder costs associated with suicidal behaviours, including suicide ideation or self-harm threat. This study aims to estimate first responder resource use and costs associated with suicidal behaviour ambulance presentations and compare them to general ambulance presentations.
METHODS: We used the 2022 Victorian National Ambulance Surveillance System (NASS), and Ambulance Victoria datasets to determine the mean duration and first responder costs (personnel, vehicle, travel and consumables) associated with suicidal behaviour and general ambulance presentations. Personnel costs were determined by multiplying the length of an ambulance presentation by the paramedic and/or police wage. Non-personnel costs were calculated by subtracting personnel costs from total ambulance presentation cost (as per Ambulance Victoria) and adjusting for mean presentation length. All costs are reported in 2022 AUD. T-tests were performed to identify significant differences (p<0.05) in duration and costs between ambulance presentations classified as suicidal behaviour and general physical.
RESULTS: The mean duration (mean costs) for individuals transported to hospital for suicide behaviour was 144 minutes (cost=$1,717), which was similar in duration (146 minutes), yet significantly costlier compared to physical ambulance presentations (cost=$1,530). Police mean personnel costs were $120 for suicide related ambulance presentations and $4 for general physical presentations. Within the suicide behaviour cohort, suicide attempt ($1,729), suicide ideation ($1,704), self-harm threat ($1,715) and self-harm injury ($1,743) had similar first responder costs.
CONCLUSIONS: This study found that suicidal behaviour ambulance presentations were similar in length, but significantly costlier compared to general health ambulance presentations, with police co-attendance contributing to higher costs. The high costs associated with suicide ideation and self-harm threat, due to their almost universal transport to hospital, emphasise the need for alternative and more efficient models of care for these presentations.