scholarly journals 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 Control Center (OFF-RESCUE)

2020 ◽  
Author(s):  
Marc S. Schehadat ◽  
Guido Scherer ◽  
David A. Groneberg ◽  
Manfred Kaps ◽  
Michael H.K. Bendels
Keyword(s):  
Emergency Medical Service ◽  
Rural Areas ◽  
Urban Areas ◽  
Medical Service ◽  
Transport Service ◽  
Economic Point ◽  
Control Center ◽  
Patient Transport ◽  
Medical Control ◽  
Emergency Medical

Abstract 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 control center (EMCC) 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 (ORON 3.6, 95 % CI 3.21-3.30; OROFF 3.18, 95 % CI 3.04-3.32). OFF-Missions last 47.2 minutes (SD 42.3; CI 46.9-47.4), while ON-Missions are processed after 79.7 minutes on average (SD 47.6; CI 79.6-79.9). ON-Missions generated a turnover of more than € 114 million, while OFF-Missions made a loss of almost € 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.

scholarly journals 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 control center (OFF-RESCUE)

2020 ◽  
Author(s):  
Marc S. Schehadat ◽  
Guido Scherer ◽  
David A. Groneberg ◽  
Manfred Kaps ◽  
Michael H.K. Bendels
Keyword(s):  
Emergency Medical Service ◽  
Rural Areas ◽  
Urban Areas ◽  
Medical Service ◽  
Transport Service ◽  
Economic Point ◽  
Control Center ◽  
Patient Transport ◽  
Medical Control ◽  
Emergency Medical

Abstract BackgroundThe 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.MethodsThis analysis examined N=819,780 missions of the EMS and patient transport service (PTS) in the catchment area of the emergency medical control center (EMCC) 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).Results53.4 % 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 (ORON 3.6, 95 % CI 3.21-3.30; OROFF 3.18, 95 % CI 3.04-3.32). OFF-Missions last 47.2 minutes (SD 42.3; CI 46.9-47.4), while ON-Missions are processed after 79.7 minutes on average (SD 47.6; CI 79.6-79.9). ON-Missions generated a turnover of more than € 114 million, while OFF-Missions made a loss of almost € 13 million.ConclusionsThis 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.

scholarly journals 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)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marc S. Schehadat ◽  
Guido Scherer ◽  
David A. Groneberg ◽  
Manfred Kaps ◽  
Michael H. K. Bendels
Keyword(s):  
Emergency Medical Service ◽  
Rural Areas ◽  
Urban Areas ◽  
Medical Service ◽  
Transport Service ◽  
Emergency Medical Dispatch ◽  
Economic Point ◽  
Patient Transport ◽  
Emergency Medical ◽  
Dispatch Centre

Abstract 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 (ORON 3.6, 95% CI 3.21–3.30; OROFF 3.18, 95% CI 3.04–3.32). OFF-Missions 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 € 114 million, while OFF-Missions made a loss of almost € 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.

scholarly journals Helicopter Emergency Medical Service (HEMS) Response in Rural Areas in Poland: Retrospective Study

2019 ◽  
Vol 16 (9) ◽  
pp. 1532 ◽  
Author(s):  
Patryk Rzońca ◽  
Stanisław Paweł Świeżewski ◽  
Rakesh Jalali ◽  
Joanna Gotlib ◽  
Robert Gałązkowski
Keyword(s):  
Cardiovascular Diseases ◽  
Emergency Medical Service ◽  
Rural Areas ◽  
Medical Service ◽  
Clinical Status ◽  
Sudden Cardiac Arrest ◽  
Final Analysis ◽  
Helicopter Emergency Medical Service ◽  
Health Problems ◽  
Emergency Medical

The aim of the study was to identify the characteristics of missions performed by HEMS (Helicopter Emergency Medical Service) crews and the analysis of health problems, which are the most common cause of intervention in rural areas in Poland. The study was conducted using a retrospective analysis based on the medical records of patients provided by the HEMS crew, who were present for the emergencies in rural areas in the period from January 2011 to December 2018. The final analysis included 37,085 cases of intervention by HEMS crews, which accounted for 54.91% of all the missions carried out in the study period. The majority (67.4%) of patients rescued were male, and just under a quarter of those rescued were aged between 50–64 years. Injuries (51.04%) and cardiovascular diseases (36.49%) were the main diagnoses found in the study group. Whereas injuries were significantly higher in the male group and patients below 64 years of age, cardiovascular diseases were higher in women and elderly patients (p < 0.001). Moreover, in the group of women myocardial infarction was significantly more frequent (30.95%) than men, while in the group of men head injuries (27.10%), multiple and multi-organ injuries (25.93%), sudden cardiac arrest (14.52%), stroke (12.19%), and epilepsy (4.95%) was significantly higher. Factors that are associated with the most common health problems of rural patients are: gender and age, as well as the seasons of the year and the values of the Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), and National Advisory Committee for Aeronautics (NACA) used to assess the clinical status of patients.

Results of the reform of the emergency medical service in the Pavlodar Region

2020 ◽  
pp. 67-71
Author(s):  
Kanadan Kanashevich Akhmetzhanov
Keyword(s):  
Medical Care ◽  
Emergency Medical Service ◽  
Rural Areas ◽  
Medical Equipment ◽  
Medical Service ◽  
Medical Personnel ◽  
Emergency Medical ◽  
Medical Teams ◽  
Service Introduction ◽  
And Training

Improving the organization of medical care allows providing standardized and timely medical care of higher quality not only to residents of cities, but also to the population living in rural areas. This is achieved by the gradual reorganization of the emergency medical service, introduction of innovative technologies, 100 % provision of ambulances with medical equipment, and training of medical personnel of emergency medical teams.

scholarly journals SP6-65 Emergency medical service through community based volunteers in rural areas Bangladesh

2011 ◽  
Vol 65 (Suppl 1) ◽  
pp. A472-A472
Author(s):  
M. J. Hossain ◽  
A. K. M. F. Rahman ◽  
A. Rahman ◽  
S. R. Mashreky ◽  
K. U. Baset ◽  
...  
Keyword(s):  
Emergency Medical Service ◽  
Rural Areas ◽  
Medical Service ◽  
Community Based ◽  
Emergency Medical

scholarly journals Polish Medical Air Rescue Crew Interventions Concerning Neonatal Patients

Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 557
Author(s):  
Ewa Rzońca ◽  
Grażyna Bączek ◽  
Marcin Podgórski ◽  
Robert Gałązkowski
Keyword(s):  
Emergency Medical Service ◽  
Urban Areas ◽  
Medical Service ◽  
Helicopter Emergency Medical Service ◽  
Air Rescue ◽  
Medical Emergency ◽  
Emergency Procedures ◽  
Emergency Medical ◽  
Common Diagnosis ◽  
Medical Air

The purpose of the study was to present the characteristics of Helicopter Emergency Medical Service (HEMS) and Emergency Medical Service (EMS) interventions concerning newborns in Poland. The study involved a retrospective analysis of missions by Polish Medical Air Rescue crews concerning newborns, carried out in Poland between January 2011 and December 2020. Polish Medical Air Rescue crews were most commonly dispatched to urban areas (86.83%), for patient transfer (59.67%), using an airplane (65.43%), between 7 AM and 6:59 PM (93.14%), and in the summer (28.67%). Further management involved handing over the neonatal patient to a ground neonatal ambulance team. Most of the patients studied were male (58.02%), and the most common diagnosis requiring the HEMS or EMS intervention was a congenital heart defect (31.41%). The most common medical emergency procedure performed by Polish Medical Air Rescue crew members for the neonatal patients was intravenous cannulation (43.07%). The odds ratio for congenital malformations was higher in male newborns. The type of Polish Medical Air Rescue mission was associated with the location of the call, time of the call, ICD-10 diagnosis associated with the dispatch, selected clinical findings, most commonly performed medical emergency procedures, and mission duration and distance covered.

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