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Association of Ambulance Utilization in New York City with the Implementation of the Affordable Care Act

Charles Courtemanche,

Andrew Friedson,

and Daniel Rees

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Expanding insurance coverage may be associated with overuse of medical care because newly insured patients are insulated from having to pay the full cost.


To examine the use of ambulance transport before and after the rollout of the Patient Protection and Affordable Care Act (ACA) in New York City (NYC), New York.

Design, Setting, and Participants  

In this case-control study, the volume of ambulance dispatches in NYC for minor injuries before and after the rollout of the ACA was examined. Data were drawn from a census of all ambulance dispatches in NYC between January 1, 2013, and July 31, 2016. Ambulance dispatches for more severe injuries, which are more difficult to characterize as unnecessary, were used as the control group. Analyses were conducted from August 17, 2017, to May, 10, 2019.

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