Aim In the light of increasing demand for emergency medical services (EMS)1 and a scarcity of studies about repeated EMS users,2 we aimed to examine the extent of repeated users and compare their characteristics and diagnoses with one-time users. Additional knowledge about repeated users may help identify appropriate alternative interventions.
Methods Population-based cohort study on patients to whom an emergency ambulance was dispatched after an emergency call in the North Denmark Region (5 80 000 inhabitants), 2012–2013. Each patient was included at first ambulance dispatch and followed one year. One-time users (one ambulance dispatched) were compared to repeated users divided into: moderate (2–4), frequent (5–9), and super users (≥10). Hospital diagnoses according to ICD-10 were retrieved.
Results We identified 36 210 patients corresponding to 46 203 emergency ambulances dispatched within the one-year follow-up. The results below are presented according to the four groups: one-time, moderate, frequent, and super users. Percentage of patients (ambulances): 83.2% (65.2%), 15.8% (28.9%), 0.9% (4.2%), 0.1% (1.7%). Male gender: 53%, 56%, 59%, 62%. Median age (interquartile range): 55 (29–72), 61 (41–77), 55 (40–71), 52 (37–68). Charlson comorbidity index ≥3: 3%, 12%, 16%, 13%. Percentage diagnosed with mental disorders (ICD-10 chapter 5; n=2,149): 4%, 6%, 12%, 19%. Respiratory diseases (ICD-10 chapter 10; n=3,033): 5%, 9%, 14%, 25%. Injuries, poisoning, and external causes (ICD-10 chapter 19, n=11,709): 33%, 20%, 15%, 9%.
Conclusion Repeated EMS users constituted 16.8% of patients (34.8% of ambulances). Compared to one-time users, repeated users were more often male, had higher comorbidity, were more often diagnosed with mental and respiratory illnesses, and less often with injuries, poisoning, and external causes.
Christensen EF, Larsen TM, Jensen FB, Bendtsen MD, Hansen PA, Johnsen SP, et al. Diagnosis and mortality in prehospital emergency patients transported to hospital: a population-based and registry-based cohort study. BMJ Open2016;6(7):e011558.
Scott J, Strickland AP, Warner K, Dawson P. Frequent callers to and users of emergency medical systems: a systematic review. Emerg Med J2014Aug;31(8):684–91.
Conflict of interest None declared.
Funding None declared.
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