&lt;p&gt;Sociodemographic Characteristics Associated with Contacts to Emergency Medical Services and Out-of-Hours Primary Care: An Observational Study of 2.3 Million Citizens&lt;/p&gt;

Søvsø, Morten Breinholt; Bech, Bodil Hammer; Christensen, Helle Collatz; Huibers, Linda; Christensen, Erika Frischknecht; Christensen, Morten Bondo

doi:10.2147/clep.s243531

Cited by 14 publications

(9 citation statements)

References 38 publications

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“…A previous Danish study, also with data from 2016, found an association between education and likelihood of contacting EMS where low education was associated with greater likelihood of calling 1-1-2. 8 In addition, a Canadian study have shown that patients who are frequent users of ambulances have difficulty getting the money to last a month. 19 Another Danish study based on data from a medical helpline in the capital, Copenhagen, covering 1.8 million people, found that callers with low income were less often triaged to subsequent face-to-face clinical assessment compared with callers with middle/high SES and the same trend was observed for 30-day mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Co-variates are factors related to frequent use of emergency health services for people living in high-income countries, 8 , 19 which are also potentially related to socioeconomic position and therefore potential confounding factors. Included covariates were sex, age, cohabitation and comorbidity.…”

Section: Methodsmentioning

confidence: 99%

“…There are studies reporting SES-related differences in use of prehospital emergency medical services (EMS). 7 , 8 However, more detailed data on the potential differences in the quality of the EMS according to SES are lacking.…”

Section: Introductionmentioning

confidence: 99%

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Socioeconomic Disparities in Prehospital Emergency Care in a Danish Tax-Financed Healthcare System: Nationwide Cohort Study

Frydenlund¹,

Mackenhauer²,

Christensen³

et al. 2022

CLEP

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Background Differences related to socioeconomic status (SES) in use of prehospital emergency medical services (EMS) have been reported. However, detailed data on potential disparities in the quality of the EMS according to SES are lacking. Methods A nationwide cohort study of medical emergency calls made to the Danish emergency number 1-1-2 in the period 2016–2017. To measure quality of care, performance indicators from the Danish Quality Registry for Prehospital Emergency Medical Services were used. SES was based on income, education and adherence to workforce. Poisson regression was used to measure relative risk (RR). Results We included 388,378 medical 1-1-2 calls, of which 261,771 were unique individuals; 42% of the calls concerned patients with low education, 5% concerned patients living in relative poverty and 23% concerned patients receiving social subsidy. There were no significant differences between the SES regarding time span for arrival of first EMS units. However, patients receiving social subsidy and retired people were more likely to be released at scene and to call again within 24 hours: Adjusted RRs were 2.79 [2.20; 3.54] and 2.08 [1.58; 2.75], respectively, compared with patients having a job. In addition, patients receiving social subsidy and retired people were more likely to call again within 24 hours after receiving telephone advice only: Adjusted RRs 2.35 [1.95; 2.82] and 1.88 [1.51; 2.35], respectively compared with patients having a job. Adjusted RRs for unplanned hospital contact after being treated and released at scene were higher for patients receiving social subsidy and retired people, respectively, relative to patients having a job. Conclusion Patients with low SES were significantly more likely to contact the hospital or EMS again after their first call or after treatment and release at scene compared with patients with high SES. This indicates that callers with low SES did not receive the appropriate help.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Socioeconomic Disparities in Prehospital Emergency Care in a Danish Tax-Financed Healthcare System: Nationwide Cohort Study

Frydenlund¹,

Mackenhauer²,

Christensen³

et al. 2022

CLEP

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“…patients presenting with chest pain [ 14 ]. The association of EMS utilization with age [ 15 – 17 ] as well as frailty [ 18 ] has likewise been described. Male gender did not constitute an independent EMS utilization predictor in our cohort, as opposed to other studies [ 16 , 19 ] not limited to respiratory patients.…”

Section: Main Textmentioning

confidence: 99%

“…family members for transport, but this remains speculative. In this context, a large observational study from Denmark had identified living alone as a determinant of utilizing EMS, besides age, low income and receipt of cash benefits [ 17 ].…”

Section: Main Textmentioning

confidence: 99%

Diverting less urgent utilizers of emergency medical services to primary care: is it feasible? Patient and morbidity characteristics from a cross-sectional multicenter study of self-referring respiratory emergency department consulters

et al. 2021

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Objective Diversion of less urgent emergency medical services (EMS) callers to alternative primary care (PC) is much debated. Using data from the EMACROSS survey of respiratory ED patients, we aimed to characterize self-referred EMS patients, compare these with non-EMS patients, and assess scope and acceptability of a potential redirection to alternative PC. Results Of n = 292 self-referred patients, n = 99 were transported by EMS. Compared to non-EMS patients, these were older, triaged more urgently and arrived out-of-hours more frequently. The share of chronically and severely ill patients was greater. Out-of-hours ED visit, presence of a chronic pulmonary condition as well as a hospital diagnosis of respiratory failure were identified as determinants of EMS utilization in a logistic model, while consultation for access and quality motives as well as migrant status decreased the probability. EMS-transported lower urgency outpatients visiting during regular physicians’ hours were defined as potential PC cases and evaluated descriptively (n = 9). As a third was medically complex and potentially less suitable for PC, redirection potential could be estimated at only 6% of EMS cases. This would be reduced to 2% if considering patients’ judgment concerning the appropriate setting. Overall, the scope for PC diversion of respiratory EMS patients seems limited.

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Einfluss des sozioökonomischen Status auf Art und Häufigkeit notärztlicher Einsätze

Arrich,

Dammann,

Reichel

et al. 2024

Notfall Rettungsmed

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Zusammenfassung Hintergrund In den vergangenen Jahren hat die Anzahl der notärztlichen Rettungsdiensteinsätze signifikant zugenommen und die adäquate Gesundheitsversorgung vor Herausforderungen gestellt. Studien haben gezeigt, dass ein niedrigerer sozioökonomischer Status (SES) mit einer höheren Inanspruchnahme der notfallmedizinischen Einrichtungen verbunden ist. Ziel dieser Studie war es, einen möglichen Zusammenhang zwischen dem sozioökonomischen Status und den notärztlichen Einsätzen zu finden und diesen hinsichtlich der Erstdiagnose und der Erkrankungsschwere weiter zu charakterisieren. Methoden Im Rahmen einer retrospektiven Kohortenstudie wurden die Protokolle der im Jahr 2019 in Jena durchgeführten notärztlichen Einsätze analysiert. Der SES wurde auf Aggregatebene anhand der Wohngebiete der PatientInnen über Indikatoren wie Armutsverteilung, Jugendarbeitslosigkeit, Wohnfläche je Einwohner und Migrationshintergrund definiert. Die Endpunkte der Analyse waren die notärztliche Einsatzrate, die Erstdiagnose und die Erkrankungsschwere der PatientInnen. Die Resultate wurden für das Alter und das Geschlecht der PatientInnen angepasst. Ergebnisse Die notärztlichen Einsatzraten lagen für PatientInnen in sozioökonomisch benachteiligten Gebieten um 33 % höher als in den anderen Gebieten Jenas (adjustierte Odds ration (OR) 1,33; 95 %-Konfidenzintervall (KI) 1,25–1,42). Bei PatientInnen mit niedrigerem SES war die Erstdiagnose einer psychiatrischen Erkrankung um 63 % häufiger (OR 1,63; 95 %-KI 1,26–2,10), die einer pulmonalen Erkrankung um 37 % häufiger (OR 1,37; 95 %-KI 1,06–1,80) als bei PatientInnen mit einem höheren SES. Der SES hatte keinen signifikanten Einfluss auf die Erkrankungsschwere der PatientInnen. Diskussion Ein niedrigerer SES ist in bestimmten Wohngebieten mit einer relevant höheren Rate an notärztlichen Einsätzen und einem höheren Anteil an psychiatrischen und pulmologischen Erstdiagnosen vergesellschaftet. Dies könnte ein Indikator für eine strukturelle Unterversorgung der regulären medizinischen Einrichtungen und eine höhere Krankheitsbelastung in Gebieten mit niedrigerem SES sein. Es bedarf weiterer gezielter Interventions- und Evaluationsstudien, um die Ursachen des erhöhten Aufkommens an notärztlichen Einsätzen zu identifizieren, die reguläre Gesundheitsversorgung dieser Gebiete zu verbessern und Rettungsdienste und nachgeschaltete Notfallzentren zu entlasten. Graphic abstract

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<p>Sociodemographic Characteristics Associated with Contacts to Emergency Medical Services and Out-of-Hours Primary Care: An Observational Study of 2.3 Million Citizens</p>

Cited by 14 publications

References 38 publications

Socioeconomic Disparities in Prehospital Emergency Care in a Danish Tax-Financed Healthcare System: Nationwide Cohort Study

Socioeconomic Disparities in Prehospital Emergency Care in a Danish Tax-Financed Healthcare System: Nationwide Cohort Study

Diverting less urgent utilizers of emergency medical services to primary care: is it feasible? Patient and morbidity characteristics from a cross-sectional multicenter study of self-referring respiratory emergency department consulters

Einfluss des sozioökonomischen Status auf Art und Häufigkeit notärztlicher Einsätze

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