S Pekanoja1, M Hoikka2, H Kyngäs3, S Elo3. 1. Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland. 2. Division of Intensive Care, Department of Anaesthesiology, Medical Research Centre, Research Unit of Surgery, Anaesthesia and Intensive Care, Oulu University Hospital, University of Oulu, Oulu, Finland. 3. Research Unit of Nursing Science and Health Management, Medical Research Centre, Oulu University Hospital, University of Oulu, Oulu, Finland.
Abstract
BACKGROUND: In Finland, approximately 40% of emergency medical service (EMS) missions do not result in transport of the patient to a hospital by ambulance, and there is wide variability in the reasons underlying non-transport decisions. The aim of this study was to describe the context of these EMS non-transport missions. METHODS: The data were collected retrospectively between 3 September and 20 October 2014 by investigating non-transport EMS charts (n = 1154). Event information and patients' main symptoms were extracted from information found in EMS charts and quantified using content and statistical analyses. RESULTS: Patients' need for EMS were explained by various reasons. One-third of the missions were caused by organ-specific symptoms, whereas in 30.8% of cases the reason for EMS was unspecified. Sudden onset symptoms were noted for 38.4% of the cases, whereas in 14.7% of cases the symptoms had persisted for days or weeks before EMS contact. EMS personnel offered guidance instead of treatment in 79.2% of the missions. CONCLUSIONS: Non-transport missions represent a significant daily work load for the EMS. Although most of the symptoms showed acute onset, the majority of these missions involved only assessment of medical necessity and/or guidance without any medical treatment. It is questionable whether this use of the EMS is cost-effective for any healthcare system.
BACKGROUND: In Finland, approximately 40% of emergency medical service (EMS) missions do not result in transport of the patient to a hospital by ambulance, and there is wide variability in the reasons underlying non-transport decisions. The aim of this study was to describe the context of these EMS non-transport missions. METHODS: The data were collected retrospectively between 3 September and 20 October 2014 by investigating non-transport EMS charts (n = 1154). Event information and patients' main symptoms were extracted from information found in EMS charts and quantified using content and statistical analyses. RESULTS:Patients' need for EMS were explained by various reasons. One-third of the missions were caused by organ-specific symptoms, whereas in 30.8% of cases the reason for EMS was unspecified. Sudden onset symptoms were noted for 38.4% of the cases, whereas in 14.7% of cases the symptoms had persisted for days or weeks before EMS contact. EMS personnel offered guidance instead of treatment in 79.2% of the missions. CONCLUSIONS: Non-transport missions represent a significant daily work load for the EMS. Although most of the symptoms showed acute onset, the majority of these missions involved only assessment of medical necessity and/or guidance without any medical treatment. It is questionable whether this use of the EMS is cost-effective for any healthcare system.
Authors: Jani Paulin; Akseli Reunamo; Jouni Kurola; Hans Moen; Sanna Salanterä; Heikki Riihimäki; Tero Vesanen; Mari Koivisto; Timo Iirola Journal: BMC Med Inform Decis Mak Date: 2022-06-23 Impact factor: 3.298
Authors: Lilian C M Vloet; Arjan de Kreek; Emmelieke M C van der Linden; Jori J A van Spijk; Vince A H Theunissen; Maud van Wanrooij; Pierre M van Grunsven; Remco H A Ebben Journal: Scand J Trauma Resusc Emerg Med Date: 2018-10-29 Impact factor: 2.953