Outpatient care in acute and prehospital emergency medicine by emergency medical and patient transport service over a 10-year period: a retrospective study based on dispatch data from a German emergency medical dispatch centre (OFF-RESCUE).
Dublin Core
Title
Outpatient care in acute and prehospital emergency medicine by emergency medical and patient transport service over a 10-year period: a retrospective study based on dispatch data from a German emergency medical dispatch centre (OFF-RESCUE).
Subject
OFF-Mission, ON-Mission, Emergency medical control center, Triaged, Dispatched, Rural, Urban, Job
cycle time, Prehospital emergency care, Emergency medical dispatch
cycle time, Prehospital emergency care, Emergency medical dispatch
Description
Background
The number of operations by the German emergency medical service almost doubled between 1994 and 2016.
The associated expenses increased by 380% in a similar period. Operations with treatment on-site, which
retrospectively proved to be misallocated (OFF-Missions), have a substantial proportion of the assignment of the
emergency medical service (EMS). Besides OFF-Missions, operations with patient transport play a dominant role
(named as ON-Missions). The aim of this study is to work out the medical and economic relevance of both
operation types.
Methods
This analysis examined N = 819,780 missions of the EMS and patient transport service (PTS) in the catchment
area of the emergency medical dispatch centre (EMDC) Bad Kreuznach over the period from 01/01/2007 to
12/31/2016 in terms of triage and disposition, urban-rural distribution, duration of operations and economic
relevance (p < .01).
Results
53.4% of ON-Missions are triaged with the indication non-life-threatening patient transport; however, 63.7% are
processed by the devices of the EMS. Within the OFF-Mission cohort, 78.2 and 85.8% are triaged or dispatched
for the EMS. 74% of all ON-Missions are located in urban areas, 26% in rural areas; 81.3% of rural operations
are performed by the EMS. 66% of OFF-Missions are in cities. 93.2% of the remaining 34% of operations in rural
locations are also performed by the EMS. The odds for both ON- and OFF-Missions in rural areas are
significantly higher than for PTS (OR.sub.ON 3.6, 95% CI 3.21-3.30; OR.sub.OFF 3.18, 95% CI 3.04-3.32). OFFMissions last 47.2 min (SD 42.3; CI 46.9-47.4), while ON-Missions are processed after 79.7 min on average (SD
47.6; CI 79.6-79.9). ON-Missions generated a turnover of more than [euro] 114 million, while OFF-Missions
made a loss of almost [euro] 13 million.
Conclusions
This study particularly highlights the increasing utilization of emergency devices; especially in OFF-Missions, the
resources of the EMS have a higher number of operations than PTS. OFF-Missions cause immensely high costs
due to misallocations from an economic point of view. Appropriate patient management appears necessary from
both medical and economic perspective, which requires multiple solution approaches.
The number of operations by the German emergency medical service almost doubled between 1994 and 2016.
The associated expenses increased by 380% in a similar period. Operations with treatment on-site, which
retrospectively proved to be misallocated (OFF-Missions), have a substantial proportion of the assignment of the
emergency medical service (EMS). Besides OFF-Missions, operations with patient transport play a dominant role
(named as ON-Missions). The aim of this study is to work out the medical and economic relevance of both
operation types.
Methods
This analysis examined N = 819,780 missions of the EMS and patient transport service (PTS) in the catchment
area of the emergency medical dispatch centre (EMDC) Bad Kreuznach over the period from 01/01/2007 to
12/31/2016 in terms of triage and disposition, urban-rural distribution, duration of operations and economic
relevance (p < .01).
Results
53.4% of ON-Missions are triaged with the indication non-life-threatening patient transport; however, 63.7% are
processed by the devices of the EMS. Within the OFF-Mission cohort, 78.2 and 85.8% are triaged or dispatched
for the EMS. 74% of all ON-Missions are located in urban areas, 26% in rural areas; 81.3% of rural operations
are performed by the EMS. 66% of OFF-Missions are in cities. 93.2% of the remaining 34% of operations in rural
locations are also performed by the EMS. The odds for both ON- and OFF-Missions in rural areas are
significantly higher than for PTS (OR.sub.ON 3.6, 95% CI 3.21-3.30; OR.sub.OFF 3.18, 95% CI 3.04-3.32). OFFMissions last 47.2 min (SD 42.3; CI 46.9-47.4), while ON-Missions are processed after 79.7 min on average (SD
47.6; CI 79.6-79.9). ON-Missions generated a turnover of more than [euro] 114 million, while OFF-Missions
made a loss of almost [euro] 13 million.
Conclusions
This study particularly highlights the increasing utilization of emergency devices; especially in OFF-Missions, the
resources of the EMS have a higher number of operations than PTS. OFF-Missions cause immensely high costs
due to misallocations from an economic point of view. Appropriate patient management appears necessary from
both medical and economic perspective, which requires multiple solution approaches.
Creator
Marc S. Schehadat, Guido Scherer, David A. Groneberg, Manfred Kaps and Michael H. K. Bendels
Publisher
BMC Emergency Medicine
Date
Mar. 9, 2021
Contributor
Fajar bagus w
Format
PDF
Language
Indonesia
Type
Text
Files
Collection
Citation
Marc S. Schehadat, Guido Scherer, David A. Groneberg, Manfred Kaps and Michael H. K. Bendels, “Outpatient care in acute and prehospital emergency medicine by emergency medical and patient transport service over a 10-year period: a retrospective study based on dispatch data from a German emergency medical dispatch centre (OFF-RESCUE).,” Repository Horizon University Indonesia, accessed April 4, 2025, https://repository.horizon.ac.id/items/show/3774.