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Emergency Call versus General Practitioner Requested Ambulances - Patient Mortality, Disease Severity and Pattern
Morten Breinholt Søvsø1, Rasmine Birch Haurum2, Trine Hagelskær Ebbesen2
1Centre for Prehospital and Emergency Research at Danish Centre for Health Services Research; Aalborg University Hospital and Department of Clinical Medicine, Aalborg University, Gistrup, Denmark.
Clinical Epidemiology
|August 5, 2024
Summary
General practitioner-requested ambulance patients are older, have more comorbidities, and experience higher 30-day mortality than emergency call patients, challenging assumptions about emergency care demand.
Area of Science:
- Emergency Medicine
- Public Health
- Geriatric Medicine
Background:
- Ambulance requests by general practitioners (GP-requested) are often overlooked in emergency care demand studies.
- GP-requested patients represent a significant, yet understudied, demographic within emergency medical services (EMS).
Purpose of the Study:
- To compare the acute severity, ICU admission rates, diagnostic patterns, comorbidity, and mortality of GP-requested ambulance patients versus emergency call patients.
- To test the hypothesis that emergency call patients exhibit more severe health issues than GP-requested patients.
Main Methods:
- A historical population-based cohort study in the North Denmark Region (2016-2020).
- Linked hospital contact data, ambulance records, vital signs, and vital status using unique patient identifiers.
- Primary outcome: 30-day mortality; Secondary outcomes: modified National Early Warning Score (mNEWS2) and ICU admission.
Main Results:
- GP-requested patients (46.7%) were older (median 73 vs. 61 years) and had higher comorbidity rates (11.9% vs. 4.9%).
- GP-requested patients showed higher 30-day mortality (9.0% vs. 5.2%) despite lower prehospital mNEWS2 scores.
- Circulatory and respiratory diseases were more frequent among GP-requested patients.
Conclusions:
- GP-requested patients comprise nearly half of EMS volume and present with significant acute severity and higher mortality.
- Findings indicate that GP-requested patients are a vulnerable group requiring careful consideration in emergency care planning.
- The study highlights the need to include GP-requested ambulance data in analyses of emergency care demand.
Keywords:
after-hours carediagnosesearly warning scoresemergency medical servicesgeneral practitionersmortalityprimary healthcareMore Related Videos
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