Observational studyBMC health services research2019
Contacting out-of-hours primary care or emergency medical services for time-critical conditions - impact on patient outcomes.
Observational study in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
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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
17 citing papers in PubMed.
- Stroke recognition and early care pathways following telephone triage in out-of-hours primary care: a register-based study from the Central Denmark Region.Scandinavian journal of primary health care · 2026Article
- Eye-related emergency calls and prehospital management in region Zealand, Danmark: a register-based cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Decision to initiate transport to either Stroke Unit or local emergency department for patients with suspected stroke - a cohort study.BMC emergency medicine · 2026Article
- Prehospital stroke triage in Denmark: a retrospective observational study of emergency medical services handling confirmed stroke cases not admitted directly to a stroke unit.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Observational
- Criteria codes for unrecognized stroke/TIA patients by Emergency Medical Services dispatchers in Copenhagen, Denmark.BMC emergency medicine · 2025Article
- Ongoing Opioid Treatment and Symptoms of Myocardial Infarction in Calls to the Emergency Medical Services.JACC. Advances · 2024Article
- Patients suffering traumatic brain injury: patient characteristics, prehospital triage, primary referral and mortality - A population-based follow-up study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Observational
- Disparities in prehospital and emergency surgical care among patients with perforated ulcers and a history of mental illness: a nationwide cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Dispatcher Stroke/TIA Recognition in Emergency Medical Call Center and Out-of-Hours Service Calls in Copenhagen, Denmark.Neurology. Clinical practice · 2023Article
- Recognition of visual symptoms in stroke: a challenge to patients, bystanders, and Emergency Medical Services.BMC emergency medicine · 2023Article
- Impact of integrating out-of-hours services into Emergency Medical Services Copenhagen: a descriptive study of transformational years.International journal of emergency medicine · 2022Article
- Is tele-diagnosis of dental conditions reliable during COVID-19 pandemic? Agreement between tentative diagnosis via synchronous audioconferencing and definitive clinical diagnosis.Journal of dentistry · 2022Article
- New clinical prediction model for early recognition of sepsis in adult primary care patients: a prospective diagnostic cohort study of development and external validation.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Article
- Pre-hospital predictors of an adverse outcome among patients with dyspnoea as the main symptom assessed by pre-hospital emergency nurses - a retrospective observational study.BMC emergency medicine · 2020Observational
- Characteristics and outcomes of patients with dyspnoea as the main symptom, assessed by prehospital emergency nurses- a retrospective observational study.BMC emergency medicine · 2020Observational
- Development of a clinical prediction rule for sepsis in primary care: protocol for the TeSD-IT study.Diagnostic and prognostic research · 2020Article
- Sociodemographic Characteristics Associated with Contacts to Emergency Medical Services and Out-of-Hours Primary Care: An Observational Study of 2.3 Million Citizens.Clinical epidemiology · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOut-of-hours (OOH) healthcare services in Western countries are often differentiated into out-of-hours primary healthcare services (OOH-PC) and emergency medical services (EMS). Call waiting time, triage model and intended aims differ between these services. Consequently, the care pathway and outcome could vary based on the choice of entrance to the healthcare system. We aimed to investigate patient pathways and 1- and 1-30-day mortality, intensive care unit (ICU) stay and length of hospital stay for patients with acute myocardial infarction (AMI), stroke and sepsis in relation to the OOH service that was contacted prior to the hospital contact.
methodsPopulation-based observational cohort study during 2016 including adult patients from two Danish regions with an OOH service contact on the date of hospital contact. Patients <18 years were excluded. Data was retrieved from OOH service databases and national registries, linked by a unique personal identification number. Crude and adjusted logistic regression analyses were performed to assess mortality in relation to contacted OOH service with OOH-PC as the reference and cox regression analysis to assess risk of ICU stay.
resultsWe included 6826 patients. AMI and stroke patients more often contacted EMS (52.1 and 54.1%), whereas sepsis patients predominately called OOH-PC (66.9%). Less than 10% (all diagnoses) of patients contacted both OOH-PC & EMS. Stroke patients with EMS or OOH-PC & EMS contacts had higher likelihood of 1- and 1-30-day mortality, in particular 1-day (EMS: OR = 5.33, 95% CI: 2.82-10.08; OOH-PC & EMS: OR = 3.09, 95% CI: 1.06-9.01). Sepsis patients with EMS or OOH-PC & EMS contacts also had higher likelihood of 1-day mortality (EMS: OR = 2.22, 95% CI: 1.40-3.51; OOH-PC & EMS: OR = 2.86, 95% CI: 1.56-5.23) and 1-30-day mortality. Risk of ICU stay was only significantly higher for stroke patients contacting EMS (EMS: HR = 2.38, 95% CI: 1.51-3.75). Stroke and sepsis patients with EMS contact had longer hospital stays.
conclusionsMore patients contacted OOH-PC than EMS. Sepsis and stroke patients contacting EMS solely or OOH-PC & EMS had higher likelihood of 1- and 1-30-day mortality during the subsequent hospital contact. Our results suggest that patients contacting EMS are more severely ill, however OOH-PC is still often used for time-critical conditions.
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