Which is better? Comparing the efficiency and information accuracy of pre-hospital emergency medical services (PEMS) dispatch in two call modes in Sichuan Province, China: a retrospective study

Abstract

Background China's PEMS system was established in the 1980s. Due to economic and resource inequalities, China's PEMS system does not have a uniform mode, and regions developed their models based on their circumstances, incorporating North America’s and Europe’s experiences. In the Sichuan PEMS model, when someone calls "120" for a pre-hospital emergency, he/she will first access the Medical Emergency Center, a dispatcher will record the incident information and makes a preliminary judgment, then that information and the judgment will be forwarded to a nearby general hospital, which will send an ambulance staffed by medical workers to provide PEMS. Instead, some people prefer to call hospitals directly for pre-hospital emergencies and communicate directly with medical staff. Which call mode is better has long been a point of contention. Methods This retrospective study included a total of 496 PEMS within 8 km of the participating hospital between 2020 and 2021. Cases that called the Emergency Medical Center dispatcher were classified as "referral group" (n = 318) and cases that called the hospital and communicated directly with medical personnel were classified as "direct group" (n = 178), and appropriate metrics were selected to measure efficiency and information accuracy Results There was no significant difference in the efficiency of PEMS between the two groups, but there was a notable difference in the information accuracy between the two groups on all indicators Conclusion Compared with calling ‘120’, direct PEMS calls to general hospitals have obvious advantages in terms of information accuracy. Perhaps the Emergency Medical Center in Sichuan could try to reform as a supervisory agency for PEMS instead of a dispatch agency or adopt the Shenzhen EMS model where the Emergency Medical Center, after receiving a call for help, transfers the call to the appropriate hospital based on the caller's location and situation, allowing the caller to communicate directly with medical personnel.