Evidence map›Paper›PMID 40205478›Full record

ArticleScandinavian journal of trauma, resuscitation and emergency medicine2025

Exploring care pathways of patients conveyed by emergency medical services (EMS) through electronic health records.

Jani Paulin, Teijo I Saari, Heikki Riihimäki, Mari Koivisto, Laura-Maria Peltonen

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In one paragraph

Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. 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

5 authors.

Jani PaulinTurku University of Applied Sciences and University of Turku, Turku, Finland. jani.paulin@utu.fi.ORCID http://orcid.org/0000-0002-4038-3662
Teijo I SaariDepartment of Anaesthesiology and Intensive Care, Division of Perioperative Services, Intensive Care and Pain Medicine, University of Turku, Turku University Hospital, Turku, Finland.ORCID http://orcid.org/0000-0003-1225-4561
Heikki RiihimäkiThe wellbeing services county of Southwest Finland, Turku University of Applied Sciences, Turku, Finland.
Mari KoivistoDepartment of Biostatistics, University of Turku, Turku University Hospital, Turku, Finland.
Laura-Maria PeltonenDepartment of Health and Social Management, University of Eastern Finland and Wellbeing Services County of North Savo, Kuopio, Finland.ORCID http://orcid.org/0000-0001-5740-6480

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEmergency Medical Services (EMS) and Emergency Departments (ED) have reported increased patient volumes in the last decades. Despite high rates of non-conveyance decisions, unnecessary conveyances by EMS still occur. The aim of this study was to explore care pathways of conveyed patients by EMS through registry data.

methodsThis was a retrospective cohort study of EMS patients in Finland. The primary outcomes were EMS recontacts and visits to a primary health care facility or ED within seven days. The secondary outcome was mortality within one week. Univariate and multivariable associations between the outcome variables and categorical variables were analysed with logistic regression. Results are presented with odds ratios (ORs) together with 95% confidence intervals (CIs) and p-values.

resultsThe conveyed patients' visits to health care facilities were mainly brief. EMS arrival during night-time (20:00-08:00) (OR 1.69; 95% CI 1.59 to 1.80), in urban area (OR 1.21; 95% CI 1.13 to 1.29) and alcohol use (OR 2.55; 95% CI 2.26 to 2.86) predicted short ED visits (< 24 h). 77% of the patients were discharged from primary health care within one hour (median 22 min, IQR 18-60). After EMS conveyance and visit to the ED or primary health care facility, 10.5% of the patients were readmitted within one week. Non-urgent patients (OR 1.26; 95% CI 1.14 to 1.39), an EMS mission at night (OR 1.36; 95% CI 1.24 to 1.50), and based on univariate analyses, the usage of alcohol (OR 1.26; 95% CI 1.09 to 1.45) increased the likelihood of a readmission. 449 patients of all conveyed EMS patients (n = 20376) died within one week (2.2%).

conclusionsEMS non-conveyance reduces patient flow in EDs, but there is a possibility that more could be done related to unnecessary conveyances to health care facilities, especially in urban areas and at night. The pathway analyses of post conveyance re-contacts show that a small number of patients burden the system. Further in-depth studies are needed to understand of unnecessary conveyances, find solutions, and provide repeated users the appropriate care.

Indexed as

Critical PathwaysElectronic Health RecordsEmergency Medical ServicesEmergency Service, HospitalAdultAgedFemaleFinlandHumansMaleMiddle AgedRegistriesRetrospective StudiesCare pathwayConveyanceEmergency medical servicePrehospital emergency careRecontactSubsequent event

Identifiers

PMID40205478
PMCPMC11983912

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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.