When do emergencies happen? Exploring circadian, weekly, and seasonal trends in ambulance calls in Cyprus

The demand for ambulances has steadily risen over the past few decades, straining Emergency Medical Services (EMS) and emergency departments (EDs). Understanding the temporal patterns of emergency calls can improve ED patient flow. The aim of this study was to analyze the overall demand for emergency ambulance calls in Cyprus focusing on call reasons, time of day, day of the week, and year season.

This retrospective descriptive study analyzed emergency call data from the Cyprus Ambulance Service (2018-2022). Descriptive statistics summarized emergency call distributions by priority level, year season, weekday, and time of day. Frequencies and percentages were reported, and chi-square tests assessed differences (p < 0.05). Statistical analysis was performed using STATA v14, with results presented in tables and figures.

A total of 148,043 emergency calls were analyzed, with RED (32.5 %) (high priority) and BLACK (11.1 %) (lowest priority - dead patient) cases peaking in winter (27.9 %), followed by spring (27.7 %). Monday recorded the highest overall demand (14.9 %), while RED emergencies peaked on Fridays and Sundays (14.7 %). The highest call volume occurred between 8 am and 12 pm (25.1 %), reflecting increased daytime activity. The most common emergency categories were unwell patients (25 %), falls (11 %), respiratory problems (10 %), and road traffic accidents (9 %), with their frequency varying throughout the day. Notably, traffic accidents were most frequent between 1 pm and 7 pm, particularly on Mondays and Fridays, while other medical emergencies exhibited peak demand in the late morning and early evening hours.

Emergency ambulance calls in Cyprus peaked in winter, especially severe cases (despite the fact that Cyprus population is more than double during summer due to tourism). Weekly trends showed highest demand on Mondays, while life-threatening cases increased on Fridays and Sundays. The most frequent call reasons displayed distinct daily and weekly patterns.