Swedish emergency medical services’ identification of potential candidates for primary healthcare: Retrospective patient record study

Objective: To investigate patients who called the emergency medical services (EMS) for primary healthcare (PHC) problems. Design: A retrospective and exploratory patient record study from an EMS perspective, comparing two groups: those who were potential candidates for PHC and those who were not. All data were gathered from EMS and hospital records. Settings: The study was completed at the EMS and five hospital areas in the western region of Sweden. Subjects: The patients (n = 3001) who called the EMS in 2011. Data were missing for 10%. Main outcome measures: The frequency and the clinical characteristics of the patients who called the EMS and were actually potential candidates for PHC. Results: Of a total of 2703 patients, a group of 426 (16%) were assessed as potential candidates for PHC and could thus be treated at a level of care other than the emergency department. Patients who were classified as suitable for PHC were found at all priority levels and within all symptom groups, but were younger and healthier than the other group. Conclusion: Numerous patients seeking help from the EMS do not end up at the most appropriate level in the healthcare system. Implications: In the EMS, guidelines are needed to enable pre-hospital emergency nurses to assess and triage patients to the most appropriate level of healthcare. KEY POINTS: Patients calling the emergency medical services do not always end up at an appropriate level of healthcare. In total, 16% of patients were identified by the Swedish emergency medical services as potential candidates for primary healthcare. These patients were younger and healthier than those needing care at the emergency department. They were found at all priority levels and within all symptom groups.