Why are people without medical needs transported by ambulance? A study of indications for pre-hospital care

Hjälte, Lena; Suserud, Björn-Ove; Herlitz, Johan; Karlberg, Ingvar

doi:10.1097/mej.0b013e3280146508

Cited by 86 publications

(77 citation statements)

References 8 publications

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“…• Patient compliance with treatment recommendations given 31,53 • Paramedic documentation 45,66 • To identify target populations 29,30,55 • Characteristics of patients who paramedics judged were "medically unnecessary" to transport to ED described. 55 • How practitioners make decisions 52 • Analyze cases to determine key aspects of decision making styles.…”

Section: ;17(5)mentioning

confidence: 99%

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Alternatives to Traditional EMS Dispatch and Transport: A Scoping Review of Reported Outcomes

Jensen

Carter

Rose

et al. 2015

CJEM

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Objectives: Emergency medical services (EMS) programs, which provide an alternative to traditional EMS dispatch or transport to the emergency department (ED), are becoming widely implemented. This scoping review identified and catalogued all outcomes used to measure such alternative EMS programs. Data Source: Broad systematized bibliographic and grey literature searches were conducted. Study Selection: Inclusion criteria were 911 callers/EMS patients, reported on alternatives to traditional EMS dispatch OR traditional EMS transport to the ED, and reported an outcome measure. Data Extraction: The reports were categorized as either alternative to dispatch or to EMS transport, and outcome measures were categorized and described. Data Synthesis: The bibliographic search retrieved 13,215 records, of which 34 articles met the inclusion criteria, with an additional 10 added from reference list hand-searching (n = 44 included). In the grey literature search, 31 websites were identified, from which four met criteria and were retrieved (n = 4 included). Fifteen reports (16 studies) described alternatives to EMS dispatch, and 33 reports described alternatives to EMS transport. The most common outcomes reported in the alternatives to EMS dispatch reports were service utilization and decision accuracy. Twenty-four different specific outcomes were reported. The most common outcomes reported in the alternatives to EMS transport reports were service utilization and safety, and 50 different specific outcomes were reported. Conclusions: Numerous outcome measures were identified in reports of alternative EMS programs, which were catalogued and described. Researchers and program leaders should achieve consensus on uniform outcome measures, to allow benchmarking and improve comparison across programs. RÉSUMÉObjectif: Les programmes de services médicaux d'urgence (SMU), qui offrent une solution de rechange à la répartition traditionnelle des SMU ou au transport classique des malades aux services des urgences (SU), gagnent de plus en plus de terrain. Dans l'examen d'établissement de la portée décrit ici, les auteurs ont relevé et classé tous les résultats utilisés pour mesurer l'efficacité de ces programmes novateurs de SMU. Sources des données: Les auteurs ont entrepris une vaste recherche systématisée de références bibliographiques, et effectué des recherches méthodiques dans la documentation parallèle. Sélection des études: Les critères de sélection comprenaient les appels faits aux services d'urgence 911 ou les malades examinés par les SMU, inscrits dans les rapports de solutions de rechange à la répartition traditionnelle des SMU OU au transport classique des malades au SU par les SMU, ainsi que l'existence d'un critère d'évaluation. Extraction des données: Les rapports ont été classés soit dans la catégorie des solutions de rechange à la répartition des services, soit dans la catégorie des solutions de rechange aux transports effectués par les SMU; quant aux critères d'évaluation, ils ont été classés et décrits. Synthèse...

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Section: ;17(5)mentioning

confidence: 99%

“…55 • How practitioners make decisions 52 • Analyze cases to determine key aspects of decision making styles. 52 Alternatives to Traditional EMS Dispatch and Transport CJEM JCMU 2015;17 (5) three randomized controlled trials, three studies with a non-randomized comparison group, and three studies from another population or simulation.…”

Section: ;17(5)mentioning

confidence: 99%

Alternatives to Traditional EMS Dispatch and Transport: A Scoping Review of Reported Outcomes

Jensen

Carter

Rose

et al. 2015

CJEM

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“…Up to 40-50% of patient requests for emergency transport have been described as potentially avoidable or unnecessary, [44][45][46][47][48][49][50] being more suited to alternative community services, such as social, psychiatric or district nursing services 44 ; or warranting transport to the ED by alternative means such as a non-emergency vehicle. 49 However, it is difficult to define what is inappropriate or unnecessary, as clinicians and patients may hold different viewpoints. To date inappropriate usage has been mostly defined only from the clinician's perspective.…”

Section: Appropriate Use and Accessibility To Alternative Servicesmentioning

confidence: 99%

Increasing utilisation of emergency ambulances

Lowthian¹,

Cameron²,

Stoelwinder³

et al. 2011

Aust. Health Review

188

161

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Background. Increased ambulance utilisation is closely linked with Emergency Department (ED) attendances. Pressures on hospital systems are widely acknowledged with ED overcrowding reported regularly in the media and peer-reviewed literature. Strains on ambulance services are less well-documented or studied.Aims. To review the literature to determine the trends in utilisation of emergency ambulances throughout the developed world and to discuss the major underlying drivers perceived as contributing to this increase.Method. A search of online databases, search engines, peer-reviewed journals and audit reports was undertaken. Findings. Ambulance utilisation has increased in many developed countries over the past 20 years. Annual growth rates throughout Australia and the United Kingdom are similar. Population ageing, changes in social support, accessibility and pricing, and increasing community health awareness have been proposed as associated factors. As the extent of their contribution has not yet been established these factors were reviewed.Conclusion. The continued rise in utilisation of emergency ambulances is placing increasing demands on ambulance services and the wider health system, potentially compromising access, quality, safety and outcomes. A variety of factors may contribute to this increase and targeted strategies to reduce utilisation will require an accurate identification of the major drivers of demand.What is known about the topic? Ambulance utilisation is increasing annually throughout the developed world, with previous research suggesting numerous underlying factors. What does this paper add? These factors have not been previously synthesised in the international literature. This narrative review clearly articulates the underlying problems. What are the implications for practitioners? This paper outlines the need for further research of the causes of increased emergency ambulance utilisation, to enable the development of appropriate strategies to manage demand in the future.

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“…Kako u svom radu navode Hjälte i sar. [15] Hitna pomoć kao organizacija mora da razvije jasne kriterijume za korišćenje automobila hitne pomoći koja će biti prihvaćena i implementirana od strane dispečerskog centra i medicinskih radnika. Ovi kriterijumi moraju da uključe i sigurnosne granice i u isto vreme i odgovarajuće korišćenje resursa.…”

Section: Diskusijaunclassified

Uticaj korišćenja protokola „Indeks urgentnog zbrinjavanja“ na procenu tegoba i hitnosti pacijenta

Zivanovic¹,

Stanković

2015

Biomedicinska istraž.

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1 Gradski zavod za hitnu medicinsku pomoć, Beograd, Srbija 2 Dom zdravlja Pirot, Srbija Kratak sadržajUvod. Godine 2006. Gradski zavod za hitnu medicinsku pomoć (HP) u Beogradu je počeo da koristi "Indeks urgentnog zbrinjavanja" (Index), uputstvo za rad na telefonskoj centrali 194. Index se sastoji od "start strane" i 38 grupa tegoba, stanja i definisanih pitanja koja operater mora da postavi pozivaocu zavisno na koje tegobe ukazuje. Tegobe koje navede operater na telefonskom broju 194 ne slažu se uvek sa onim tegobama na koje se žali pacijent lekaru HP koji je pored njega. Često ne postoji slaganje između procene hitnosti operatera na telefonskoj centrali i lekara uz pacijenta. Cilj rada je bio da se analizira uticaj Index-a na tačno prepoznavanje tegoba, kao i na broj crvenih poziva i pravilnu procenu hitnosti stanja pacijenta koju daje operater.Metode. Analiziran je rad jednog lekara na terenu u periodu od 14.05.2003. godine do 17.02.2012. godine u kom su izvršene 6324 intervencije koje su podeljene u tri grupe: pre primene Index-a, neposredno posle uvođenja Index-a, kao i tokom njegove kasnije upotrebe.Rezultati. Slaganje tegoba pacijenta koje je registrovao operater i onih koje je utvrdio lekar bilo je 80% u prvom, 85% u drugom i 90% u trećem periodu u kojima je pregledano po 2108 pacijenata. Broj crveno označenih poziva je po periodima bio 81, 1015 i 247. Procentualno slaganje procene crvene hitnosti operatera na telefonu 194 sa procenom lekara na terenu povećalo se u drugom periodu da bi se u trećem periodu praktično vratilo na stanje u prvom periodu.Zaključak. Rastući procenat dobro procenjenih tegoba i crvenih poziva operatera direktna su posledica korišćenja Index-a.Ključne reči: hitna medicinska pomoć, Beograd, prijem poziva, hitnost, Indeks urgentnog zbrinjavanja Adresa autora: Prim. dr Slavoljub Živanović Mrakovička 25/26,

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Why are people without medical needs transported by ambulance? A study of indications for pre-hospital care

Cited by 86 publications

References 8 publications

Alternatives to Traditional EMS Dispatch and Transport: A Scoping Review of Reported Outcomes

Alternatives to Traditional EMS Dispatch and Transport: A Scoping Review of Reported Outcomes

Increasing utilisation of emergency ambulances

Uticaj korišćenja protokola „Indeks urgentnog zbrinjavanja“ na procenu tegoba i hitnosti pacijenta

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