Evidence map›Paper›PMID 35984572›Full record

ArticleCJEM2022

Increased demand for paramedic transports to the emergency department in Ontario, Canada: a population-level descriptive study from 2010 to 2019.

Ryan P Strum, Ian R Drennan, Fabrice I Mowbray, Shawn Mondoux, Andrew Worster, Glenda Babe, Andrew P Costa

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CJEM, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing 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

10 citing papers in PubMed.

  1. Trial
  2. Article
  3. Observational
  4. Article
  5. Patients' pathways to the emergency department: a scoping review.International journal of emergency medicine · 2024
    Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
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, Hamilton, ON, Canada. Strumr@mcmaster.ca.ORCID http://orcid.org/0000-0003-1902-4734
Ian R DrennanDepartment of Family and Community Medicine, Division of Emergency Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Fabrice I MowbrayDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Shawn MondouxDepartment of Medicine, Division of Emergency Medicine, McMaster University, Hamilton, ON, Canada.
Andrew WorsterDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Glenda BabeInstitute for Clinical Evaluative Sciences, McMaster University, Hamilton, ON, Canada.
Andrew P CostaDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe examined changes in annual paramedic transport incidence over the ten years prior to COVID-19 in comparison to increases in population growth and emergency department (ED) visitation by walk-in.

methodsWe conducted a population-level cohort study using the National Ambulatory Care Reporting System from January 1, 2010 to December 31, 2019 in Ontario, Canada. We included all patients triaged in the ED who arrived by either paramedic transport or walk-in. We clustered geographical regions using the Local Health Integration Network boundaries. Descriptive statistics, rate ratios (RR), and 95% confidence intervals were calculated to explore population-adjusted changes in transport volumes.

resultsOverall incidence of paramedic transports increased by 38.3% (n = 264,134), exceeding population growth fourfold (9.4%) and walk-in ED visitation threefold (13.4%). Population-adjusted transport rates increased by 26.2% (rate ratio 1.26, 95% CI 1.26-1.27) compared to 3.4% for ED visit by walk-in (rate ratio 1.03, 95% CI 1.03-1.04). Patient and visit characteristics remained consistent (age, gender, triage acuity, number of comorbidities, ED disposition, 30-day repeat ED visits) across the years of study. The majority of transports in 2019 had non-emergent triage scores (60.0%) and were discharged home directly from the ED (63.7%). The largest users were persons aged 65 or greater (43.7%). The majority of transports occurred in urbanized regions, though rural and northern regions experienced similar paramedic transport growth rates.

conclusionThere was a substantial increase in the demand for paramedic transportation. Growth in paramedic demand outpaced population growth markedly and may continue to surge alongside population aging. Increases in the rate of paramedic transports per population were not bound to urbanized regions, but were province-wide. Our findings indicate a mounting need to develop innovative solutions to meet the increased demand on paramedic services and to implement long-term strategies across provincial paramedic systems.

Indexed as

COVID-19Allied Health PersonnelCohort StudiesEmergency Service, HospitalHumansInfantOntarioRetrospective StudiesEmergency departmentEmergency medical servicesEpidemiologyParamedicPrehospital

Identifiers

PMID35984572
PMCPMC9389513

What OpenQuestion holds

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Registered trials

None linked

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.