Epidemiology of prehospital emergency calls according to patient transport decision in a middle eastern emergency care environment: Retrospective cohort‐based

Hassan Farhat*, Guillaume Alinier, Kawther El Aifa, Ahmed Makhlouf, Padarath Gangaram, Ian Howland, Andre Jones, Cyrine Abid, Mohamed Chaker Khenissi, Ian Howard, Moncef Khadhraoui, Nicholas R. Castle, Loua Al Shaikh, James Laughton, Imed Gargouri

*Corresponding author for this work

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Abstract

Background and Aim
Though emergency medical services (EMS) respond to all types of emergency calls, they do not always result in the patient being transported to the hospital. This study aimed to explore the determinants influencing emergency call-response-based conveyance decisions in a Middle Eastern ambulance service.

Methods
This retrospective quantitative analysis of 93,712 emergency calls to the Hamad Medical Corporation Ambulance Service (HMCAS) between January 1 and May 31, 2023, obtained from the HMCAS electronic system, was analyzed to determine pertinent variables. Sociodemographic, emergency dispatch-related, clinical, and miscellaneous predictors were analyzed. Descriptive, bivariate, ridge logistic regression, and combination analyses were evaluated.

Results
23.95% (N = 21,194) and 76.05% (N = 67,285) resulted in patient nontransport and transportation, respectively. Sociodemographic analysis revealed that males predominantly activated EMS resources, and 60% of males (n = 12,687) were not transported, whilst 65% of females (n = 44,053) were transported. South Asians represented a significant proportion of the transported patients (36%, n = 24,007). “Home” emerged as the primary emergency location (56%, n = 37,725). Bivariate analysis revealed significant associations across several variables, though multicollinearity was identified as a challenge. Ridge regression analysis underscored the role of certain predictors, such as missing provisional diagnoses, in transportation decisions. The upset plot shows that hypertension and diabetes mellitus were the most common combinations in both groups.

Conclusions
This study highlights the nuanced complexities governing conveyance decisions. By unveiling patterns such as male predominance, which reflects Qatar's expatriate population, and specific temporal EMS activity peaks, this study accentuates the importance of holistic patient assessment that transcends medical histories.
Original languageEnglish
Article numbere2056
Number of pages13
JournalHealth Science Reports
Volume7
Issue number4
Early online date23 Apr 2024
DOIs
Publication statusPublished - Apr 2024
Externally publishedYes

Keywords

  • emergency medical service
  • Middle East
  • patient decisions
  • cohort study
  • prehospital care

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