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BMJ Open. 2016 Oct 26;6(10):e013849. doi: 10.1136/bmjopen-2016-013849.

Factors associated with the difficulty in hospital acceptance at the scene by emergency medical service personnel: a population-based study in Osaka City, Japan.

Author information

1
Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
2
Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan.
3
Division Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan.
4
Kyoto University Health Services, Kyoto, Japan.
5
Osaka Municipal Fire Department, Osaka, Japan.

Abstract

OBJECTIVES:

To investigate the association between the difficulty in hospital acceptance at the scene by emergency medical service (EMS) personnel and prehospital demographic factors and reasons for EMS calls.

DESIGN:

A retrospective, observational study.

SETTING:

Osaka City, Japan.

PARTICIPANTS:

A total of 100 649 patients transported to medical institutions by EMS from January 2013 to December 2013.

PRIMARY OUTCOME MEASUREMENTS:

The definition of difficulty in hospital acceptance at the scene was EMS personnel making ≥5 phone calls to medical institutions until a decision to transport was determined. Multivariable analysis was used to assess the relationship between difficulty in hospital acceptance and prehospital factors and reasons for EMS calls.

RESULTS:

Multivariable analysis showed the elderly, foreigners, loss of consciousness, holiday/weekend, and night-time to be positively associated with difficulty in hospital acceptance at the scene. As reasons for EMS calls, gas poisoning (adjusted OR 3.281, 95% CI 1.201 to 8.965), trauma by assault (adjusted OR 2.662, 95% CI 2.390 to 2.966), self-induced drug abuse/gas poisoning (adjusted OR 4.527, 95% CI 3.921 to 5.228) and self-induced trauma (adjusted OR 1.708, 95% CI 1.369 to 2.130) were positively associated with the difficulty in hospital acceptance at the scene.

CONCLUSIONS:

Ambulance records in Osaka City showed that certain prehospital factors such as night-time were positively associated with difficulty in hospital acceptance at the scene, and reasons for EMS calls, such as self-induced drug abuse/gas poisoning, were also positive predictors for difficulty in hospital acceptance at the scene.

KEYWORDS:

emergency medical service; hospital acceptance; pre-hospital factors

PMID:
27798040
PMCID:
PMC5093624
DOI:
10.1136/bmjopen-2016-013849
[Indexed for MEDLINE]
Free PMC Article

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