Keith Vodden Dr. Douglas Smith - Transports Canada
Keith Vodden Dr. Douglas Smith - Transports Canada
Keith Vodden Dr. Douglas Smith - Transports Canada
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Analysis and Estimation of the Social Cost of Motor Vehicle Collisions in Ontario<br />
6. Ambulance<br />
The Ontario Ministry of Health & Long Term Care provides grants to cover the<br />
cost of land ambulance services. Services are provided by approximately 60 certified land<br />
based municipal, private hospital and volunteer operators—serving 440 individual<br />
municipalities in Ontario. In 2004, there were over 1.6 million requests for land<br />
ambulance service resulting in approximately 940,000 transports of more than 1.1 million<br />
patients.<br />
Those transported by land ambulance for a medically necessary trip, with a valid<br />
Ontario Health Card and not subject to a Special Exemption category, are charged a copayment<br />
of $45 toward the cost of their trip. Each person whose transport is deemed<br />
medically unnecessary by the receiving hospital is charged a fixed $240 fee for a land<br />
ambulance under the Health Insurance Act, Regulation 552. This later fee is unlikely to<br />
reflect the full cost of the land ambulance trip.<br />
Instead of this regulated charge we use the cost of $783 (2005 $) per transported<br />
patient estimated based on data provided by the City of Toronto website. (The total<br />
budget for Emergency Medical Services in Toronto was approximately $130 million with<br />
166,000 transported patients in 2005. This average will include both fixed overheads and<br />
variable components of costs. However, like fire departments most costs are unavoidable<br />
and therefore an average allocation across all responses seems warranted.) In 2004<br />
dollars the cost per land-based transport by ambulance is $754. We have assumed a value<br />
one-half this amount for transport by the Coroner.<br />
We have no data on the costs for water ambulance service. Given its infrequent<br />
use related to motor vehicle collision we have assumed a cost identical to land based<br />
ambulance services.<br />
A non-profit corporation accountable to the Ontario government provides air<br />
ambulance services in Ontario. Budgets and numbers transported are not available.<br />
However, approximate values provided to us suggest an average cost of approximately<br />
$5,000 per person transported by air ambulance. Given the small number of air<br />
ambulance trips involved we use this figure despite its uncertainty.<br />
7. Tow trucks<br />
Tow truck charges are typically included in insurance claims. As a result we<br />
deduct the amount estimated for tow truck costs in this section from the estimate of<br />
insurance claims payouts. Any uncertainty in our estimate of tow truck costs is netted out<br />
in the calculation of insurance claims costs.<br />
Industry sources suggest that most motor vehicle collisions occur in areas covered<br />
by municipal contracts for tow truck services. These contracts are extremely competitive<br />
and most are “loss-leaders” for tow truck operators. Instead operators of tow trucks<br />
recoup losses on related charges for clean-up, dolly wheels, storage, compound fee, and<br />
144 TNS Canadian Facts, Social and Policy Research