It's still unplanned, since you don't know when it's going to happen; a home visit might leave 10 minutes before you need help.

As for care facilities, if the need isn't that common (e.g. once a week), is that really more effective than an occasional ambulance trip? Plus the patient might very well prefer to spend his last year as close to his family as possible.

I think the cost could well be close. Here, if you call 911 for a medical emergency you will get a police patrol car, an ambulance, and a fire truck dispatched in most cases. That's at least three vehicles and at least half a dozen people.

If this is happening once a week then it really seems there ought to be a better way to handle it.

Edit: if you also assume that an ambulance dispatch is usually followed by an ER trip, the cost balloons even more. Seems really hard to think that a 911 dispatch followed by an ER trip once a week is the best way to handle a chronically ill person at home.

I don't know the exact rules but in the UK, when calling 999 you're asked which service you require. Fire service will only get police involved when they need it or automatically when more than 2 Fire Engines are dispatched. Ambulance calls can result in an Ambulance with a crew of 2 or a single paramedic in a sensible estate car (station wagon) with a big engine, they'll call the Air Ambulance if they need one and it's free. Dispatchers will send who they think you need as they see fit. That includes Lifeboat Service or Mountain Rescue. Or Police, of course. Each service will obviously ask for backup as required.

The BIG difference with what you've described though is the layout of the UK is much denser than USA. The resources available and the nature and frequency of call outs will obviously be quite different.

How much would they save if they bought the fire department a Prius for responding to medical calls?

Chronic conditions can flare up unexpectedly. Just so you know.

Care facilities are warehouses for the old and ill. There is no care there — they just call 911.

Home visits are great for physical therapy or protocol based care. But again, they call 911 when anything significant happens.

Each individual event is unplanned and urgent (life-threatening). But he has a lot of events. He spends a few days in intensive care, gets stabilized, gets sent home, and then is fine for a while... until something happens. There are lots of people in similar situations, i.e. a person with life-threatening allergies, compromised immune systems, etc. Modern medical care means that there are more people skating closer to the edge of death than there once were.

I live next to an elderly acute care facility. There's an ambulance outside every day when I drive or ride my bike past.