Increasing emergency number utilisation is not driven by low-acuity calls : an observational study of 1.5 million emergency calls (2018-2021) from Berlin
© 2023. The Author(s)..
BACKGROUND: The Emergency Medical Service (EMS) in Germany is increasingly challenged by strongly rising demand. Speculations about a greater utilisation for minor cases have led to intensive media coverage, but empirical evidence is lacking. We investigated the development of low-acuity calls from 2018 to 2021 in the federal state of Berlin and its correlations with sociodemographic characteristics.
METHODS: We analysed over 1.5 million call documentations including medical dispatch codes, age, location and time using descriptive and inferential statistics and multivariate binary logistic regression. We defined a code list to classify low-acuity calls and merged the dataset with sociodemographic indicators and data on population density.
RESULTS: The number of emergency calls (phone number 112 in Germany) increased by 9.1% from 2018 to 2021; however, the proportion of low-acuity calls did not increase. The regression model shows higher odds of low-acuity for young to medium age groups (especially for age 0-9, OR 1.50 [95% CI 1.45-1.55]; age 10-19, OR 1.77 [95% CI 1.71-1.83]; age 20-29, OR 1.64 [95% CI 1.59-1.68] and age 30-39, OR 1.40 [95% CI 1.37-1.44]; p < 0.001, reference group 80-89) and for females (OR 1.12 [95% CI 1.1-1.13], p < 0.001). Odds were slightly higher for calls from a neighbourhood with lower social status (OR 1.01 per index unit increase [95% CI 1.0-1.01], p < 0.05) and at the weekend (OR 1.02 [95% CI 1.0-1.04, p < 0.05]). No significant association of the call volume with population density was detected.
CONCLUSIONS: This analysis provides valuable new insights into pre-hospital emergency care. Low-acuity calls were not the primary driver of increased EMS utilisation in Berlin. Younger age is the strongest predictor for low-acuity calls in the model. The association with female gender is significant, while socially deprived neighbourhoods play a minor role. No statistically significant differences in call volume between densely and less densely populated regions were detected. The results can inform the EMS in future resource planning.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
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| Enthalten in: |
BMC medicine - 21(2023), 1 vom: 16. Mai, Seite 184 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Herr, David [VerfasserIn] |
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| Links: |
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| Themen: |
112 |
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| Anmerkungen: |
Date Completed 18.05.2023 Date Revised 26.05.2023 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1186/s12916-023-02879-7 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM356965988 |
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| 245 | 1 | 0 | |a Increasing emergency number utilisation is not driven by low-acuity calls |b an observational study of 1.5 million emergency calls (2018-2021) from Berlin |
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| 520 | |a © 2023. The Author(s). | ||
| 520 | |a BACKGROUND: The Emergency Medical Service (EMS) in Germany is increasingly challenged by strongly rising demand. Speculations about a greater utilisation for minor cases have led to intensive media coverage, but empirical evidence is lacking. We investigated the development of low-acuity calls from 2018 to 2021 in the federal state of Berlin and its correlations with sociodemographic characteristics | ||
| 520 | |a METHODS: We analysed over 1.5 million call documentations including medical dispatch codes, age, location and time using descriptive and inferential statistics and multivariate binary logistic regression. We defined a code list to classify low-acuity calls and merged the dataset with sociodemographic indicators and data on population density | ||
| 520 | |a RESULTS: The number of emergency calls (phone number 112 in Germany) increased by 9.1% from 2018 to 2021; however, the proportion of low-acuity calls did not increase. The regression model shows higher odds of low-acuity for young to medium age groups (especially for age 0-9, OR 1.50 [95% CI 1.45-1.55]; age 10-19, OR 1.77 [95% CI 1.71-1.83]; age 20-29, OR 1.64 [95% CI 1.59-1.68] and age 30-39, OR 1.40 [95% CI 1.37-1.44]; p < 0.001, reference group 80-89) and for females (OR 1.12 [95% CI 1.1-1.13], p < 0.001). Odds were slightly higher for calls from a neighbourhood with lower social status (OR 1.01 per index unit increase [95% CI 1.0-1.01], p < 0.05) and at the weekend (OR 1.02 [95% CI 1.0-1.04, p < 0.05]). No significant association of the call volume with population density was detected | ||
| 520 | |a CONCLUSIONS: This analysis provides valuable new insights into pre-hospital emergency care. Low-acuity calls were not the primary driver of increased EMS utilisation in Berlin. Younger age is the strongest predictor for low-acuity calls in the model. The association with female gender is significant, while socially deprived neighbourhoods play a minor role. No statistically significant differences in call volume between densely and less densely populated regions were detected. The results can inform the EMS in future resource planning | ||
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| 650 | 4 | |a Low-acuity | |
| 650 | 4 | |a Overload | |
| 700 | 1 | |a Bhatia, Sangeeta |e verfasserin |4 aut | |
| 700 | 1 | |a Breuer, Florian |e verfasserin |4 aut | |
| 700 | 1 | |a Poloczek, Stefan |e verfasserin |4 aut | |
| 700 | 1 | |a Pommerenke, Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Dahmen, Janosch |e verfasserin |4 aut | |
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