CHARACTERISTIC OF EMERGENCY MEDICAL SERVICES TO THE PATIENT WITH CARDIOLOGICAL PROFILE IN THE SOUTH KAZAKHSTAN REGION

Purpose. Assessment of the received emergency medical services (EMS) in patients with cardiological profile in the South Kazakhstan region.Materials and methods. A sociological study was carried out among three compared groups: group 1 — patients of the regional cardiological center (312); 2nd — those who applied to rural outpatient clinics, polyclinics, hospitals (244), and the 3rd — who applied to the central district hospital (228).Results. The analysis showed that 65.1% of the respondents applied for EMS over the diseases of the circulatory system, mostly they did it 1–2 times a year (44.9%), less often several times a month (15.1%). Several times a week 5.1% of patients were called to EMS. It was found that in 65.5% of cases there was a rapid arrival of the EMS, less than 20 minutes. It should be noted that a long wait for the arrival of the EMS (45 minutes or more) took place in 10.2% of cases. The waiting time, as the reason for the dissatisfaction of the EMS, was more often called the respondents of the 2 nd and 3 rd groups — 94.1% and 93.9% versus 76.5% in the 1st group (p < 0.05). Inattentive attitude of the staff was more often noted by the patients of the 3rd group, and the low availability of free medication was most often indicated in the 1st group.Conclusion. The received characteristic of the EMS and its assessment by patients with diseases of the circulatory system should be taken into account when developing a package of measures to optimize cardiac care in the region.

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Differences between cases admitted to hospital and discharged from the emergency department after emergency medical services transport

BMJ Open ◽

10.1136/bmjopen-2019-030636 ◽

2019 ◽

Vol 9 (9) ◽

pp. e030636 ◽

Cited By ~ 3

Author(s):

Kathrin Hegenberg ◽

Heiko Trentzsch ◽

Stephan Prückner

Keyword(s):

Emergency Medical Services ◽

Circulatory System ◽

Secondary Data ◽

Time Of Day ◽

Medical Services ◽

System Disease ◽

Emergency Medical ◽

Icd 10 ◽

International Statistical Classification ◽

Hospital Emergency Departments

ObjectiveRising emergency medical services (EMS) utilisation increases transport to hospital emergency departments (ED). However, some patients receive outpatient treatment (discharged) while others are hospitalised (admitted). The aims of this analysis were to compare admitted and discharged cases, to assess whether cases that were discharged from the ED could be identified using dispatch data and to compare dispatch keyword categories and hospital diagnoses.DesignRetrospective observational study using linked secondary data.Setting and participants78 303 cases brought to 1 of 14 ED in the city of Munich, Germany, by EMS between 1 July 2013 and 30 June 2014.Main outcome measuresCharacteristics of admitted and discharged cases were assessed. Logistic regression was used to estimate the association between discharge and age, sex, time of day, ambulance type and dispatch keyword category. Keyword categories were compared to hospital diagnoses.Results39.4% of cases were discharged. They were especially likely to be young (OR 10.53 (CI 9.31 to 11.92), comparing <15-year-olds to >70-year-olds) and to fall under the categories ‘accidents/trauma’ (OR 2.87 (CI 2.74 to 3.01)) or ‘other emergencies (unspecified)’ (OR 1.23 (CI 1.12 to 1.34) (compared with ‘cardiovascular’). Most frequent diagnoses came from chapter ‘injury and poisoning’ (30.1%) of the 10th revision of the international statistical classification of disease and related health problems (ICD-10), yet these diagnoses were more frequent at discharge (42.7 vs 22.0%) whereas circulatory system disease was less frequent (2.6 vs 21.8%). Except for accidents/trauma and intoxication/poisoning many underlying diagnoses were observed for the same dispatch keyword.ConclusionYoung age and dispatch for accidents or trauma were the strongest predictors of discharge. Even within the same dispatch keyword category the distribution of diagnoses differed between admitted and discharged cases. Discharge from the ED does not indicate that urgent response was unnecessary. However, these cases could be suitable for allocation to hospitals with low inpatient bed capacities and are of particular interest for future studies regarding the urgency of their condition.

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