Evidence map›Paper›PMID 34641823›Full record

ArticleBMC emergency medicine2021

Examining the association between paramedic transport to the emergency department and hospital admission: a population-based cohort study.

Ryan P Strum, Fabrice I Mowbray, Andrew Worster, Walter Tavares, Matthew S Leyenaar, Rebecca H Correia, Andrew P Costa

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Ryan P StrumDepartment of Health Research Methods, Evidence and Impact, McMaster University, CRL B106, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada. Strumr@mcmaster.ca.ORCID 0000-0003-1902-4734
Fabrice I MowbrayDepartment of Health Research Methods, Evidence and Impact, McMaster University, CRL B106, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.
Andrew WorsterDepartment of Health Research Methods, Evidence and Impact, McMaster University, CRL B106, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.
Walter TavaresThe Wilson Centre, University of Toronto, Toronto, Canada.
Matthew S LeyenaarDepartment of Health Research Methods, Evidence and Impact, McMaster University, CRL B106, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.
Rebecca H CorreiaDepartment of Health Research Methods, Evidence and Impact, McMaster University, CRL B106, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.
Andrew P CostaDepartment of Health Research Methods, Evidence and Impact, McMaster University, CRL B106, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIncreasing hospitalization rates present unique challenges to manage limited inpatient bed capacity and services. Transport by paramedics to the emergency department (ED) may influence hospital admission decisions independent of patient need/acuity, though this relationship has not been established. We examined whether mode of transportation to the ED was independently associated with hospital admission.

methodsWe conducted a retrospective cohort study using the National Ambulatory Care Reporting System (NACRS) from April 1, 2015 to March 31, 2020 in Ontario, Canada. We included all adult patients (≥18 years) who received a triage score in the ED and presented via paramedic transport or self-referral (walk-in). Multivariable binary logistic regression was used to determine the association of mode of transportation between hospital admission, after adjusting for important patient and visit characteristics.

resultsDuring the study period, 21,764,640 ED visits were eligible for study inclusion. Approximately one-fifth (18.5%) of all ED visits were transported by paramedics. All-cause hospital admission incidence was greater when transported by paramedics (35.0% vs. 7.5%) and with each decreasing Canadian Triage and Acuity Scale level. Paramedic transport was independently associated with hospital admission (OR = 3.76; 95%CI = 3.74-3.77), in addition to higher medical acuity, older age, male sex, greater than two comorbidities, treatment in an urban setting and discharge diagnoses specific to the circulatory or digestive systems.

conclusionsTransport by paramedics to an ED was independently associated with hospital admission as the disposition outcome, when compared against self-referred visits. Our findings highlight patient and visit characteristics associated with hospital admission, and can be used to inform proactive healthcare strategizing for in-patient bed management.

Indexed as

Allied Health PersonnelEmergency Service, HospitalAdultAgedCohort StudiesHospitalizationHospitalsHumansMaleOntarioRetrospective StudiesAmbulanceEmergency departmentEmergency medical servicesHospital admissionHospitalizationParamedicParamedicine

Identifiers

PMID34641823
PMCPMC8506085

What OpenQuestion holds

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Registered trials

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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.