Patient and case characteristics associated with 'no paramedic treatment' for low-acuity cases referred for emergency ambulance dispatch following a secondary telephone triage

A retrospective cohort study

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3 Citations (Scopus)

Abstract


Background

Predicting case types that are unlikely to be treated by paramedics can aid in managing demand for emergency ambulances by identifying cases suitable for alternative management pathways. The aim of this study was to identify the patient characteristics and triage outcomes associated with ‘no paramedic treatment’ for cases referred for emergency ambulance dispatch following secondary telephone triage.


Methods

A retrospective cohort analysis was conducted of cases referred for emergency ambulance dispatch following secondary telephone triage between September 2009 and June 2012. Multivariable logistic regression modelling was used to identify explanatory variables associated with ‘no paramedic treatment’.


Results

There were 19,041 cases eligible for inclusion in this study over almost three years, of which 8510 (44.7%) were not treated after being sent an emergency ambulance following secondary triage. Age, time of day, pain, triage guideline group, and comorbidities were associated with ‘no paramedic treatment’. In particular, cases 0–4 years of age or those with psychiatric conditions were significantly less likely to be treated by paramedics, and increasing pain resulted in higher rates of paramedic treatment.


Conclusions

This study highlights that case characteristics can be used to identify particular case types that may benefit from care pathways other than emergency ambulance dispatch. This process is also useful to identify gaps in the alternative care pathways currently available. These findings offer the opportunity to optimise secondary telephone triage services to support their strategic purpose of minimising unnecessary emergency ambulance demand and to match the right case with the right care pathway.
Original languageEnglish
Article number8
Number of pages10
JournalScandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Volume26
Issue number1
DOIs
Publication statusPublished - 10 Jan 2018

Keywords

  • Ambulance
  • Emergency medical service communication systems
  • Emergency medical services
  • Health resources
  • Telephone
  • Triage

Cite this

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title = "Patient and case characteristics associated with 'no paramedic treatment' for low-acuity cases referred for emergency ambulance dispatch following a secondary telephone triage: A retrospective cohort study",
abstract = "BackgroundPredicting case types that are unlikely to be treated by paramedics can aid in managing demand for emergency ambulances by identifying cases suitable for alternative management pathways. The aim of this study was to identify the patient characteristics and triage outcomes associated with ‘no paramedic treatment’ for cases referred for emergency ambulance dispatch following secondary telephone triage.MethodsA retrospective cohort analysis was conducted of cases referred for emergency ambulance dispatch following secondary telephone triage between September 2009 and June 2012. Multivariable logistic regression modelling was used to identify explanatory variables associated with ‘no paramedic treatment’.ResultsThere were 19,041 cases eligible for inclusion in this study over almost three years, of which 8510 (44.7{\%}) were not treated after being sent an emergency ambulance following secondary triage. Age, time of day, pain, triage guideline group, and comorbidities were associated with ‘no paramedic treatment’. In particular, cases 0–4 years of age or those with psychiatric conditions were significantly less likely to be treated by paramedics, and increasing pain resulted in higher rates of paramedic treatment.ConclusionsThis study highlights that case characteristics can be used to identify particular case types that may benefit from care pathways other than emergency ambulance dispatch. This process is also useful to identify gaps in the alternative care pathways currently available. These findings offer the opportunity to optimise secondary telephone triage services to support their strategic purpose of minimising unnecessary emergency ambulance demand and to match the right case with the right care pathway.",
keywords = "Ambulance, Emergency medical service communication systems, Emergency medical services, Health resources, Telephone, Triage",
author = "Kathryn Eastwood and Amee Morgans and Johannes Stoelwinder and Karen Smith",
year = "2018",
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doi = "10.1186/s13049-018-0475-4",
language = "English",
volume = "26",
journal = "Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine",
issn = "1757-7241",
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T1 - Patient and case characteristics associated with 'no paramedic treatment' for low-acuity cases referred for emergency ambulance dispatch following a secondary telephone triage

T2 - A retrospective cohort study

AU - Eastwood, Kathryn

AU - Morgans, Amee

AU - Stoelwinder, Johannes

AU - Smith, Karen

PY - 2018/1/10

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N2 - BackgroundPredicting case types that are unlikely to be treated by paramedics can aid in managing demand for emergency ambulances by identifying cases suitable for alternative management pathways. The aim of this study was to identify the patient characteristics and triage outcomes associated with ‘no paramedic treatment’ for cases referred for emergency ambulance dispatch following secondary telephone triage.MethodsA retrospective cohort analysis was conducted of cases referred for emergency ambulance dispatch following secondary telephone triage between September 2009 and June 2012. Multivariable logistic regression modelling was used to identify explanatory variables associated with ‘no paramedic treatment’.ResultsThere were 19,041 cases eligible for inclusion in this study over almost three years, of which 8510 (44.7%) were not treated after being sent an emergency ambulance following secondary triage. Age, time of day, pain, triage guideline group, and comorbidities were associated with ‘no paramedic treatment’. In particular, cases 0–4 years of age or those with psychiatric conditions were significantly less likely to be treated by paramedics, and increasing pain resulted in higher rates of paramedic treatment.ConclusionsThis study highlights that case characteristics can be used to identify particular case types that may benefit from care pathways other than emergency ambulance dispatch. This process is also useful to identify gaps in the alternative care pathways currently available. These findings offer the opportunity to optimise secondary telephone triage services to support their strategic purpose of minimising unnecessary emergency ambulance demand and to match the right case with the right care pathway.

AB - BackgroundPredicting case types that are unlikely to be treated by paramedics can aid in managing demand for emergency ambulances by identifying cases suitable for alternative management pathways. The aim of this study was to identify the patient characteristics and triage outcomes associated with ‘no paramedic treatment’ for cases referred for emergency ambulance dispatch following secondary telephone triage.MethodsA retrospective cohort analysis was conducted of cases referred for emergency ambulance dispatch following secondary telephone triage between September 2009 and June 2012. Multivariable logistic regression modelling was used to identify explanatory variables associated with ‘no paramedic treatment’.ResultsThere were 19,041 cases eligible for inclusion in this study over almost three years, of which 8510 (44.7%) were not treated after being sent an emergency ambulance following secondary triage. Age, time of day, pain, triage guideline group, and comorbidities were associated with ‘no paramedic treatment’. In particular, cases 0–4 years of age or those with psychiatric conditions were significantly less likely to be treated by paramedics, and increasing pain resulted in higher rates of paramedic treatment.ConclusionsThis study highlights that case characteristics can be used to identify particular case types that may benefit from care pathways other than emergency ambulance dispatch. This process is also useful to identify gaps in the alternative care pathways currently available. These findings offer the opportunity to optimise secondary telephone triage services to support their strategic purpose of minimising unnecessary emergency ambulance demand and to match the right case with the right care pathway.

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