Abstract
Introduction Many countries face an increased use of emergency medical
services (EMS) with a decreasing percentage of life-threatening complaints.
Though there is a broad discussion among experts about the cause,
patients' self-perceived, non-medical reasons for using EMS remain
largely unknown.
Methods The written survey included EMS patients who had≥1 case of
prehospital emergency care in 2016. Four German health insurance companies sent
out postal questionnaires to 1312 insured patients. The response rate was
20%; 254 questionnaires were eligible for descriptive and interferential
analyses (t-tests, chi2-tests, logistic models).
Results The majority of respondents indicated that their EMS use was due
to an emergency or someone else’s decision (≥84%;
multiple checks allowed); 56% gave need for a quick transport as a
reason. Other frequently stated reasons addressed the health care system
(e. g., complaints outside of physicians’ opening hours) and
insecurity/anxiety about one’s state of health
(>45% of the respondents). “Social factors” were
similarly important (e. g., 42% affirming, “No one could
give me a ride to the emergency department or doctor’s
office.”). Every fifth person had contact with other emergency care
providers prior to EMS use. Respondents negating an emergency as a reason were
less likely to confirm wanting immediate medical care on site or quick
transports compared to those affirming an emergency. Patients using EMS at night
more often denied having an emergency compared to patients with access to care
during the day.
Conclusion The study identified a bundle of reasons leading to EMS use
apart from medical complaints. Attempts for needs-oriented EMS use should
essentially include optimization of the health care and social support system
and measures to reduce patients’ insecurity.
Zusammenfassung
Patient*innen des Rettungsdienstes (RD) gaben mehrheitlich an, dass ihre
RD-Nutzung durch einen Notfall, die Entscheidung Dritter oder dem Bedarf nach
einem schnellen Transport bedingt war. Andere häufig genannte
Gründe adressierten das Gesundheitssystem, Unsicherheit/Angst
über den eigenen Gesundheitszustand und soziale Faktoren.
Patient*innen, die nachts einen RD nutzen, verneinten einen Notfall mit
tendenziell höherer Wahrscheinlichkeit als Patient*innen mit
Inanspruchnahme tagsüber.
Key words
ambulance - emergency medical services - patients - prehospital emergency care - surveys and questionnaires
Schlüsselwörter
Krankenwagen - Rettungsdienst - Patienten - prehospitale Notfallversorgung - Befragungungen und Fragebögen
