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Instructions - Cost/Unit Hour Analysis Form
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Click here
to take the survey.
Line # 1: TOTAL UNIT HOURS PER WEEK:
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A unit hour is an hour in which a vehicle is actually staffed. One unit hour = one ambulance staffed with two providers for one hour. ALS vs. BLS crews are counted the same. For example:
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| Staffed Ambulances |
# of
Hours per
Day |
# of
Days per
Week |
Unit
Hours per
Week |
| 2 |
24 |
7 |
336 |
| 1 |
12 |
5 |
60 |
| 1 |
8 |
5 |
40 |
| Total Unit Hours Per Week |
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436 |
Or; another method is to complete the following chart
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# of
Ambulance
Crews |
Monday |
Tuesday |
Wednesday |
Thursday |
Friday |
Saturday |
Sunday |
Total |
| Daylight(8 hr) |
2 |
2 |
2 |
2 |
2 |
1 |
1 |
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Evening
Daylight(8 hr) |
2 |
2 |
2 |
2 |
2 |
1 |
1 |
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Midnight
Daylight(8 hr) |
1 |
1 |
1 |
1 |
1 |
1 |
1 |
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| Total |
5 |
5 |
5 |
5 |
5 |
3 |
3 |
26 |
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X 8 hr |
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8 |
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Total
MAH |
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208 |
Calculate only using the number of crews required to staff ambulances. A typical crew consists of 2 persons. However, If you have an extra EMT or Paramedic scheduled on a particular shift, you use should add .5 to the crew totals. You should also include scheduled volunteer or on-call crews which may respond from home. If a vehicle is staffed, by either paid or volunteer crew on-station or responding from home, you should count those hours in the total Unit Hours per Week.
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Line # 2: AVERAGE CALL VOLUME PER WEEK:
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Determine a number of total responses by examining all of ambulance responses - emergency and non-emergency- including no-transport calls (i.e.: refusals, cancellations, and stand-bys). This will identify your total annual responses: (all of your “out the door” calls) and divide that number by 52.07 weeks in a year. This provides you with an estimate of your estimated “Average Call Volume per Week”. Please make sure to remove any responses which are not truly and ambulance or EMS call (i.e., alternative transportation such as wheelchair van, invalid coach, etc.).
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Line # 3: UNIT HOUR UTILIZATION:
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Take the “Average Call Volume per Week” - Line #2 and divide it by “Total Unit Hours per Week” - Line #1. This results in an estimate of your average “Calls per Unit Hour”. By the way, this number can be converted from a number to a percentage - simply by moving the decimal point - two (2) spaces to the right. with the actual amount of time those units are being utilized for patient treatment and transport or other productive activity. This measurement is calculated to determine the percentage of unit hours actually consumed in productivity compared with the total staffed unit-hours.
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Line # 4: SHIFT UTILIZATION:
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Take your “Calls per Unit Hour” number and multiply it by 8 hours in a shift, giving you the estimated average “Calls per Unit Shift” number.
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List ALL ambulance related administrative and operational expenses for a fill fiscal year on Line #5a. For ambulance services that use accrual based accounting, you should not include the actual amounts paid for large capital purchases such as purchases of ambulances, building and capital equipment. Instead, you should include a total annual depreciation amounts.
Also, all services should make sure to remove any expenses that do not pertain to ambulance responses (i.e., wheelchair or invalid coach expenses, etc.).
If you are on a “accrual basis” and have included the estimated cost of depreciation for capital items such as vehicles, buildings and other capital equipment in the total listed on Line 5a, you can skip steps #5b through #5d. In this case, line #5a should equal Line #5e.
If you are on a “cash basis” and have NOT included the estimated cost of depreciation for capital items such as vehicles, buildings and other capital equipment in the total listed on Line 5a, then you should complete the steps #5b-#5e:
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Line 5b: Depreciation Cost for Ambulance(s):
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If the depreciation of your vehicle(s) is not included in your “Total Expenses”, Line #5a, you should calculate that expense and add it here. To get that number, take the cost of each vehicle and divide it by the number of years of depreciation or its “useful life” (e.g.; 5 years). Repeat this step for all emergency vehicles you have in service. Add up all the depreciation estimated for emergency vehicles and the total us your “Increase for Vehicle Depreciation” number.
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Line 5c: Depreciation Cost for Building(s):
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If the depreciation amount of your building(s) is not in your “Total Expenses”, Line #5a, you should calculate that expense and add it here. To estimate the annual depreciation for a particular building, take the cost of a building(s) and divide it by the number of years of its useful life. (e.g.: 30 years) Repeat this step for all buildings which are owned. Add up all the building depreciation costs and total - giving you the estimated “Increase for Building Depreciation” number.
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Line 5d: Depreciation Cost for Equipment:
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If the depreciation of your equipment is not in your “Total Expenses”, Line #5a, you need to calculate that expense and add it here. To get that number, take the cost of all large capital equipment (stretchers, suction units, scoop stretchers, cardiac monitors, etc.) and divide it by the estimated number of years (e.g.: 5 years for a monitor or stretcher) or “its useful life”. Repeat this step for all the equipment on your service’s capital equipment. Add up all the depreciation cost for capital equipment – the total gives you the estimated “Increase for Equipment Depreciation” number.
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Line 5e: Add Lines #5A, #5B, #5C and #5D = (#5e)
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Line # 6: TOTAL EXPENSES PER WEEK:
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Take the total listed on Line # 5E and divide it by 52.07 (the average number of weeks in a year)
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Line # 7: TOTAL EXPENSES PER DAY:
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Now that you have your estimated average “Total Expenses per Week”. Divide Line #6 by the number 7 (days in a week) which results in an estimated average of “Total Expenses per Day”.
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Line # 8: COST PER UNIT HOUR:
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Take “Total Expenses per Week” - Line #5e and divide it by your “Total Unit Hours per Week” - Line #1, which results in the estimated average “Cost per Unit Hour”.
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Line # 9: COST PER UNIT SHIFT:
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Take the “Adjusted Cost per Unit Hour” number on Line #8 and multiply that number by eight hours, giving you your “Cost per Unit Shift” number. For internal purposes, the number of hours per shift may be modified to match your desired shift length.
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Line # 10: ACTUAL COST PER CALL = (Line 9 divided by Line 4):
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Take the “Cost per Unit Shift” number on Line #9, and divide by the “Shift Utilization” number on Line #4, giving you the “Cost per Call” number.
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Line # 11: OVERALL SYSTEM COST PER CALL:
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A. Non-Transport Adjustment
Enter the percentage of your annual ambulance calls in which you
respond to a location, but do not transport a patient
(refusals, cancellations, stand-by, etc).
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___% Increase for non-transport
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B. Bad Debt / Contractual Allowance Adjustment
e.g.: If your gross collection % is 60%, then add 40% here
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___% CA / Bad Debt Allowance
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C. Enter Projected Net Revenue or Estimated Profit Margin
Net Revenue and/or profit margin is an estimated amount of excess revenue income over the expenses. No business can exist for long unless it earns net revenue or a “profit”. Non-Profit organizations should still estimate a % of net revenue, which can be reinvested back into their respective organization. Calculating net revenue or profit margin is necessary to assure new purchases of ambulances, equipment, personnel, training and so on. Some services use a straight dollar amount to estimate net revenue or profit margin, while others use a percentage of their Adjusted Cost per Call. Insert your services net revenue / profit margin on this line.
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___% Net Revenue / Profit Margin
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D. Add Lines #11A, #11B and #11C:
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___Total Adjustment % per Call
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12. ESTIMATED BILLED AMOUNT PER CALL TO MAKE PROJECTIONS:
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Take Line 11d and multiple it by Line 10, then re-add In Line 10 (Cost per Call)
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