Novel Methodology for Linking 9-1-1 Dispatch Categories with a Death Registry: Mortality Rates of Selected Dispatch...

Area of Science:

• Emergency Medical Services
• Public Health
• Medical Systems Analysis

Background:

• The Medical Priority Dispatch System (MPDS) categorizes 9-1-1 medical calls by priority (Alpha-Echo).
• Understanding MPDS code efficacy in predicting patient mortality is crucial for resource allocation and patient care improvement.

Purpose of the Study:

• To assess the methodology of matching MPDS codes with a county mortality registry.
• To evaluate the predictive ability of select MPDS codes (fall, respiratory, sick person, abdominal pain) for mortality up to 30 days post-EMS encounter.

Main Methods:

• Retrospective review of Alameda County EMS encounters from November 1, 2011, to November 1, 2016.
• Linking EMS data to the Alameda County Public Health Death Registry to determine mortality at 48 hours, 7 days, and 30 days.
• Analysis of 202,431 unique patient encounters across different age groups.

Main Results:

• Patients with respiratory complaints exhibited the highest mortality rates across all age groups (0.23% in <18, 2.7% in 18-65, 14.55% in >65).
• A significant correlation was observed between increasing MPDS priority (Alpha-Echo) for respiratory complaints and elevated 30-day mortality in adult patients (18+).
• No correlation between MPDS code and mortality was found for patients under 18.

Conclusions:

• Increasing MPDS priority designations correlate with increased mortality for adult respiratory complaints.
• Mortality rates in the studied cohort increased with age.
• The majority of deaths occurred more than 7 days after the initial EMS encounter.