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Repeated ambulance use is associated with chronic diseases - a population-based historic cohort study of patients’ symptoms and diagnoses

BACKGROUND: There is a growing demand for emergency medical services (EMS) and patients are repeatedly transported by ambulance services. For many patients, especially those with chronic disease, there may be better ways of delivering care. We examined the symptom at time of emergency call and the h...

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Autores principales: Søvsø, Morten Breinholt, Kløjgaard, Torben Anders, Hansen, Poul Anders, Christensen, Erika Frischknecht
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469091/
https://www.ncbi.nlm.nih.gov/pubmed/30992042
http://dx.doi.org/10.1186/s13049-019-0624-4
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author Søvsø, Morten Breinholt
Kløjgaard, Torben Anders
Hansen, Poul Anders
Christensen, Erika Frischknecht
author_facet Søvsø, Morten Breinholt
Kløjgaard, Torben Anders
Hansen, Poul Anders
Christensen, Erika Frischknecht
author_sort Søvsø, Morten Breinholt
collection PubMed
description BACKGROUND: There is a growing demand for emergency medical services (EMS) and patients are repeatedly transported by ambulance services. For many patients, especially those with chronic disease, there may be better ways of delivering care. We examined the symptom at time of emergency call and the hospital diagnosis for those ambulance users who repeatedly received an ambulance. METHODS: Population-based historic cohort study of patients receiving an ambulance after an emergency call between 2011 and 2014: one-time users (i.e. one ambulance run in any 12 month period) were compared to two-time users (two runs in any 12 month period) and frequent users (>two runs). The presenting symptom according to the Danish Index for Emergency Care from the EMS calls and the hospital ICD-10 discharge diagnoses were obtained from patient records. RESULTS: We included 52 533 patients (65 932 emergency ambulance runs). Repeated users constituted 16% of the patients (two-time users 11% and frequent users 5%) and one third of all ambulance runs. The symptoms showing the largest increase in frequency with increasing ambulance use were breathing difficulty (N = 3 905–15% were frequent users); seizure (N = 2 437–10% were frequent users), chest pain (N = 7 616–17% were frequent users), and alcohol intoxication (N = 1 998–5% were frequent users). The hospital diagnoses with a corresponding increase were respiratory diseases (N = 4 381) - 13% were frequent users), mental disorders (predominately abuse of alcohol) (N = 3 087–10% were frequent users) and neurological diseases (predominately epilepsy) (N = 2 207–6% were frequent users). 5% of one-time users, 12% of two-time users and 16% of frequent users had a Charlson Comorbidity Index > = 3. CONCLUSION: Repeated use of ambulance services was common and associated with chronic health problems such as chronic respiratory diseases, epilepsy, mental disorders with alcohol abuse and comorbidity. Alternative methods of caring for many of these patients should be considered. TRIAL REGISTRATION: None. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13049-019-0624-4) contains supplementary material, which is available to authorized users.
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spelling pubmed-64690912019-04-23 Repeated ambulance use is associated with chronic diseases - a population-based historic cohort study of patients’ symptoms and diagnoses Søvsø, Morten Breinholt Kløjgaard, Torben Anders Hansen, Poul Anders Christensen, Erika Frischknecht Scand J Trauma Resusc Emerg Med Original Research BACKGROUND: There is a growing demand for emergency medical services (EMS) and patients are repeatedly transported by ambulance services. For many patients, especially those with chronic disease, there may be better ways of delivering care. We examined the symptom at time of emergency call and the hospital diagnosis for those ambulance users who repeatedly received an ambulance. METHODS: Population-based historic cohort study of patients receiving an ambulance after an emergency call between 2011 and 2014: one-time users (i.e. one ambulance run in any 12 month period) were compared to two-time users (two runs in any 12 month period) and frequent users (>two runs). The presenting symptom according to the Danish Index for Emergency Care from the EMS calls and the hospital ICD-10 discharge diagnoses were obtained from patient records. RESULTS: We included 52 533 patients (65 932 emergency ambulance runs). Repeated users constituted 16% of the patients (two-time users 11% and frequent users 5%) and one third of all ambulance runs. The symptoms showing the largest increase in frequency with increasing ambulance use were breathing difficulty (N = 3 905–15% were frequent users); seizure (N = 2 437–10% were frequent users), chest pain (N = 7 616–17% were frequent users), and alcohol intoxication (N = 1 998–5% were frequent users). The hospital diagnoses with a corresponding increase were respiratory diseases (N = 4 381) - 13% were frequent users), mental disorders (predominately abuse of alcohol) (N = 3 087–10% were frequent users) and neurological diseases (predominately epilepsy) (N = 2 207–6% were frequent users). 5% of one-time users, 12% of two-time users and 16% of frequent users had a Charlson Comorbidity Index > = 3. CONCLUSION: Repeated use of ambulance services was common and associated with chronic health problems such as chronic respiratory diseases, epilepsy, mental disorders with alcohol abuse and comorbidity. Alternative methods of caring for many of these patients should be considered. TRIAL REGISTRATION: None. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13049-019-0624-4) contains supplementary material, which is available to authorized users. BioMed Central 2019-04-16 /pmc/articles/PMC6469091/ /pubmed/30992042 http://dx.doi.org/10.1186/s13049-019-0624-4 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Research
Søvsø, Morten Breinholt
Kløjgaard, Torben Anders
Hansen, Poul Anders
Christensen, Erika Frischknecht
Repeated ambulance use is associated with chronic diseases - a population-based historic cohort study of patients’ symptoms and diagnoses
title Repeated ambulance use is associated with chronic diseases - a population-based historic cohort study of patients’ symptoms and diagnoses
title_full Repeated ambulance use is associated with chronic diseases - a population-based historic cohort study of patients’ symptoms and diagnoses
title_fullStr Repeated ambulance use is associated with chronic diseases - a population-based historic cohort study of patients’ symptoms and diagnoses
title_full_unstemmed Repeated ambulance use is associated with chronic diseases - a population-based historic cohort study of patients’ symptoms and diagnoses
title_short Repeated ambulance use is associated with chronic diseases - a population-based historic cohort study of patients’ symptoms and diagnoses
title_sort repeated ambulance use is associated with chronic diseases - a population-based historic cohort study of patients’ symptoms and diagnoses
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469091/
https://www.ncbi.nlm.nih.gov/pubmed/30992042
http://dx.doi.org/10.1186/s13049-019-0624-4
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