Literature DB >> 9825272

Misuse of the London ambulance service: How much and why?

F F Palazzo1, O J Warner, M Harron, A Sadana.   

Abstract

OBJECTIVES: To assess the degree of inappropriate use of the London Ambulance Service and analyse the reasons for misuse.
DESIGN: An immediate assessment of the appropriateness of the "999" call by the ambulanceperson and casualty senior house officer followed by a retrospective review of each case by the accident and emergency (A&E) consultant.
SETTING: A busy inner London A&E department.
METHODS: Three hundred consecutive emergency ambulance arrivals to the A&E department underwent assessment as to the appropriateness of the call.
RESULTS: Overall 53.7% of patients were considered justified in their call, 15.7% of calls were inappropriate, and in 19.0% of cases a unanimous decision was not reached. Eleven per cent of all forms were incompletely filled.
CONCLUSIONS: Almost 16% of emergency ambulance calls were considered unanimously to be inappropriate. This suggests that 75,000 emergency calls per year to the London Ambulance Service are not necessary. The commonest reason for inappropriately calling an ambulance was that the caller felt that they had a serious or life threatening condition. The need for public education and deterrents of ambulance abuse are discussed. The further introduction of a nursing led triage "hot line" to appropriately dispatch ambulances according to clinical needs of the patient, and other alternatives to this are discussed.

Entities:  

Mesh:

Year:  1998        PMID: 9825272      PMCID: PMC1343207          DOI: 10.1136/emj.15.6.368

Source DB:  PubMed          Journal:  J Accid Emerg Med        ISSN: 1351-0622


  6 in total

1.  A different approach to accident and emergency services--the French experience.

Authors:  S B Fletcher
Journal:  Hosp Health Serv Rev       Date:  1978-05

2.  The use and abuse of the emergency ambulance service: some of the factors affecting the decision whether to call an emergency ambulance.

Authors:  G J Gardner
Journal:  Arch Emerg Med       Date:  1990-06

3.  Is the emergency (999) service being misused? Retrospective analysis.

Authors:  C Mann; H Guly
Journal:  BMJ       Date:  1998-02-07

4.  Getting the right ambulance to the right patient at the right time.

Authors:  A K Marsden
Journal:  Accid Emerg Nurs       Date:  1995-10

5.  What does London need from its ambulance service?

Authors:  R A Cocks; E Glucksman
Journal:  BMJ       Date:  1993-05-29

6.  Is the emergency ambulance service abused?

Authors:  D L Morris; A B Cross
Journal:  Br Med J       Date:  1980-07-12
  6 in total
  16 in total

1.  The acceptability of an emergency medical dispatch system to people who call 999 to request an ambulance.

Authors:  A O'Cathain; J Turner; J P Nicholl
Journal:  Emerg Med J       Date:  2002-03       Impact factor: 2.740

2.  The pattern of ambulance arrivals in the emergency department of an acute care hospital in Singapore.

Authors:  E Seow; H P Wong; A Phe
Journal:  Emerg Med J       Date:  2001-07       Impact factor: 2.740

3.  Rural veteran access to healthcare services: investigating the role of information and communication technologies in overcoming spatial barriers.

Authors:  Benjamin L Schooley; Thomas A Horan; Pamela W Lee; Priscilla A West
Journal:  Perspect Health Inf Manag       Date:  2010-04-01

4.  Computer assisted assessment and advice for "non-serious" 999 ambulance service callers: the potential impact on ambulance despatch.

Authors:  J Dale; J Higgins; S Williams; T Foster; H Snooks; R Crouch; C Hartley-Sharpe; E Glucksman; R Hooper; S George
Journal:  Emerg Med J       Date:  2003-03       Impact factor: 2.740

5.  Emergency (999) calls to the ambulance service that do not result in the patient being transported to hospital: an epidemiological study.

Authors:  P J Marks; T D Daniel; O Afolabi; G Spiers; J S Nguyen-Van-Tam
Journal:  Emerg Med J       Date:  2002-09       Impact factor: 2.740

6.  Results of an evaluation of the effectiveness of triage and direct transportation to minor injuries units by ambulance crews.

Authors:  H Snooks; T Foster; J Nicholl
Journal:  Emerg Med J       Date:  2004-01       Impact factor: 2.740

7.  Emergency ambulances on the public highway linked with inconvenience and potential danger to road users.

Authors:  G Saunders; A Gough
Journal:  Emerg Med J       Date:  2003-05       Impact factor: 2.740

8.  Safety of telephone consultation for "non-serious" emergency ambulance service patients.

Authors:  J Dale; S Williams; T Foster; J Higgins; H Snooks; R Crouch; C Hartley-Sharpe; E Glucksman; S George
Journal:  Qual Saf Health Care       Date:  2004-10

9.  Emergency ambulance dispatch: is there a case for triage?

Authors:  S Thakore; E A McGugan; W Morrison
Journal:  J R Soc Med       Date:  2002-03       Impact factor: 18.000

10.  The barbados emergency ambulance service: high frequency of nontransported calls.

Authors:  Sherwin E Phillips; Pamela S Gaskin; David Byer; W L Cadogan; Andrew Brathwaite; Anders L Nielsen
Journal:  Emerg Med Int       Date:  2012-11-07       Impact factor: 1.112

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