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Non-specific complaints in the ambulance; predisposing structural factors
Department of Clinical Science and Education at Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Section of Emergency Medicine, Södersjukhuset, Stockholm, Sweden.
Department of Clinical Science and Education at Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Section of Emergency Medicine, Södersjukhuset, Stockholm, Sweden.
Department of Clinical Science and Education at Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Science and Education at Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Emergency Department, Karolinska University Hospital, Solna, Sweden.
2015 (English)In: BMC Emergency Medicine, ISSN 1471-227X, E-ISSN 1471-227X, Vol. 15, article id 8Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The pre-hospital assessment non-specific complaint (NSC) often applies to patients whose diagnosis does not match any other specific assessment correlating to particular symptoms or diseases, though some previous studies have found them to be related to serious underlying conditions. The aim was to identify whether the structural factors such as urgency according to the dispatch priority of the Emergency Medical Communication Centre (EMCC) or work load in the Emergency Medical Services (EMS) are predisposing factors for the assessment of NSC instead of a specific assessment.

METHODS: All patients with assessed condition NSCs by the EMS to Södersjukhuset during 2011 (n = 493) were compared with gender- and age-matched controls (n = 493), which were randomly drawn from all patients with specific conditions in the EMS, regarding day of week, time of day and priority set by EMCC with chi-squared tests and multivariate logistic regression models.

RESULTS: Among patients with NSCs, more were females (58 %) and the median age was 82. Almost all patients were categorized with NSCs during the daytime (8 a.m. to 9 p.m.), i.e. 450 (91 %) as compared to 373 (75 %) of those with specific conditions (p < 0.01). The risk of having an EMS dispatched as low priority by the EMCC was almost doubled among patients with NSCs compared to controls (OR 1.97, 95 % CI 1.38-2.79).

CONCLUSIONS: Since patients with NSCs appear most frequently during the hours with most transportations for the EMS, i.e. 10 a.m. to 2 p.m., and the risk of having the assessment NSC was doubled if the EMCC dispatched EMS as low priority, structural factors might be predisposing factors for the assessment.

Place, publisher, year, edition, pages
BioMed Central, 2015. Vol. 15, article id 8
Keywords [en]
Aged, EMS, EMCC, Dispatch, Decision support techniques, Diagnostic errors
National Category
Medical and Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:oru:diva-69406DOI: 10.1186/s12873-015-0034-5ISI: 000210478800007PubMedID: 25971395Scopus ID: 2-s2.0-84929461636OAI: oai:DiVA.org:oru-69406DiVA, id: diva2:1254510
Note

Funding agencies:

Karolinska Institutet

Falck Foundation

Available from: 2018-10-09 Created: 2018-10-09 Last updated: 2018-10-12Bibliographically approved

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Kurland, Lisa

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