Miles, J.C. orcid.org/0000-0002-1080-768X, O'Keeffe, C., Jacques, R. et al. (2 more authors) (2018) 59 Ambulance over-conveyance to the emergency department: a large data analysis of ambulance journeys. In: BMJ Open. European Emergency Medical Services Congress (EMS2018), 16-18 Apr 2018, Copenhagen, Denmark. BMJ Publishing Group , A22-A23.
Abstract
Aim Over-conveyance by the ambulance service is a compounding factor of emergency department (ED) crowding. Previous solutions have focused on specific patient groups which have a limited impact when compared to the whole urgent and emergency care system. This study aims to analyse non-urgent conveyances by the ambulance service that could be suitable for discharge on-scene.
Results We analysed a dataset of 1,312,539 patient episodes which linked all pre-hospital emergency and urgent calls to subsequent ED attendance in 2014. The study was set in a large region in England (total population 5.3 million). As well as proportion of avoidable conveyances we also examined the association with patient age, time of arrival, re-attendance and initial triage code from ambulance dispatch.
Results There were 4 04 348 (30.8%) patients transported to ED by ambulance and of these 66 220 (16.4%) were considered potentially avoidable. There were significantly increased odds of a non-urgent conveyance out of hours (OR 1.44, 95% CI: 1.41 to 1.46). Patients aged 16–34 had the largest proportion of avoidable conveyances with 24 500 (37%). There were 13 625 (21%) episodes that were received from another healthcare professional or urgent telephone number. When analysing ED diagnosis, the highest proportion were attending with minor injury and illness, and alcohol intoxication.
Conclusion One in six ambulance conveyances to ED were deemed non-urgent. The younger population had the largest amount of preventable conveyance by ambulance with diagnoses which could be treated and discharged on-scene. Pathways and interventions would provide a larger patient benefit if they were designed around patient populations as opposed to disease specific.
Metadata
Item Type: | Proceedings Paper |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2018, Published by the BMJ Publishing Group Limited. |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 08 Mar 2019 16:36 |
Last Modified: | 08 Mar 2019 16:36 |
Published Version: | https://doi.org/10.1136/bmjopen-2018-EMS.59 |
Status: | Published |
Publisher: | BMJ Publishing Group |
Refereed: | Yes |
Identification Number: | 10.1136/bmjopen-2018-EMS.59 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:140937 |