ArticlePloS one2018
Why do ambulance services have different non-transport rates? A national cross sectional study.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- The Economic Impact of Community Paramedics Within Emergency Medical Services: A Systematic Review.Applied health economics and health policy · 2024Pooled it
- Investigating the impact of ambulance service models on paramedic delivery of end-of-life care in England: an exploratory study using case study design.BMC palliative care · 2026Article
- Prehospital data in the dark: a scoping review of the widening gap between EMS demand and the evidence to meet it.International journal of emergency medicine · 2026Review
- Serious conditions among conveyed and non-conveyed patients presenting with nonspecific chief complaints to the ambulance service.BMC emergency medicine · 2024Article
- Article
- Understanding patient non-transport decision theories in the pre-hospital setting: a narrative review.International journal of emergency medicine · 2023Review
- Rethinking non-urgent EMS conveyance to ED during night-time - a pilot study in Southwest Finland.BMC emergency medicine · 2023Article
- Epidemiological Determinants of Patient Non-Conveyance to the Hospital in an Emergency Medical Service Environment.International journal of environmental research and public health · 2023Article
- Mental health emergencies attended by ambulances in the United Kingdom and the implications for health service delivery: A cross-sectional study.Journal of health services research & policy · 2023Observational
- Reducing ambulance conveyance for older people with and without dementia: evidence of the role of social care from a regional, year-long service evaluation using retrospective routine data.British paramedic journal · 2021Article
- EMS non-conveyance: A safe practice to decrease ED crowding or a threat to patient safety?BMC emergency medicine · 2021Article
- Non-Conveyance Due to Patient-Initiated Refusal in Emergency Medical Services: A Retrospective Population-Based Registry Analysis Study in Riyadh Province, Saudi Arabia.International journal of environmental research and public health · 2021Article
- Identification of new demands regarding prehospital care based on 35,188 missions in 2018.BMC emergency medicine · 2021Article
- Assessing emergency healthcare accessibility in the Salton Sea region of Imperial County, California.PloS one · 2021Article
- Increased Emergency Calls during the COVID-19 Pandemic in Saudi Arabia: A National Retrospective Study.Healthcare (Basel, Switzerland) · 2020Article
- Knowledge, skills and attitudes of older people and staff about getting up from the floor following a fall: a qualitative investigation.BMC geriatrics · 2020Article
- Changing role of EMS -analyses of non-conveyed and conveyed patients in Finland.Scandinavian journal of trauma, resuscitation and emergency medicine · 2020Article
- Patient characteristics, triage utilisation, level of care, and outcomes in an unselected adult patient population seen by the emergency medical services: a prospective observational study.BMC emergency medicine · 2020Observational
- Exploring variation in how ambulance services address non-conveyance: a qualitative interview study.BMJ open · 2018Article
- Nontransported Cases after Emergency Medical Service Callout in the Rural and Urban Areas of the Riyadh Region.Saudi journal of medicine & medical sciencesArticle
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundSome patients calling ambulance services (known as Emergency Medical Services internationally) are not transported to hospital. In England, national ambulance quality indicators show considerable variation in non-transport rates between the ten large regional ambulance services. The aim of this study was to explain variation between ambulance services in two types of non-transport: discharge at scene and telephone advice.
methodsMixed model logistic regressions using one month of data (November 2014) from the Computer Aided Despatch systems of the ten large regional ambulance services in England.
results41% (251 677/615 815) of patients calling ambulance services were not transported to hospital. Most were discharged at scene after attendance by an ambulance (29% n = 182 479) and a small percentage were given telephone advice (7% n = 40 679). Discharge at scene rates varied by patient-level factors e.g. they were higher for elderly patients, where the reason for calling was falls, and for patients attended by paramedics with extended skills. These patient-level factors did not explain variation between ambulance services. After adjustment for patient-level factors, the following ambulance service level factors explained variation in discharge at scene rates: proportion of patients attended by paramedics with extended skills (odds ratio 1.05 (95% CI 1.04, 1.07)), the perception of ambulance service staff that paramedics with extended skills were established and valued within the workforce (odds ratio 1.84 (1.45, 2.33), and the perception of ambulance service staff that senior management viewed non-transport as risky (odds ratio 0.78 (0.63, 0.98)). Variation in telephone advice rates could not be explained.
conclusionsVariation in discharge at scene rates was explained by differences in workforce configuration and managerial motivation, factors that are largely modifiable by ambulance services.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.