ArticleScandinavian journal of trauma, resuscitation and emergency medicine2025
An analysis of characteristics and associated factors for re-contacts after EMS non-conveyance: a retrospective cohort study in the Netherlands.
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. Not yet cited in PubMed.
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Abstract
backgroundNon-conveyed patients are a significant population within ambulance care. To gain insight in patient safety for this population, ambulance re-contacts within 72 h are monitored. However, little is known about the background of these non-conveyance cases with a re-contact. This study aims to investigate the incidence of re-contacts, analyse characteristics, and identify factors associated with re-contacts following non-conveyance.
methodsThis was a retrospective cohort study of all non-conveyance cases and all associated re-contacts in two EMS regions in the Netherlands, Gelderland-Zuid and Gelderland-Midden. Data was collected from 1 January 2022 till 31 December 2022. Characteristics of non-conveyance cases with and without a re-contact within 72 h were compared and differences were analysed univariately. Logistic regression analyses were used to quantify bivariate and multivariable associations between characteristics of non-conveyance cases and EMS re-contact within 72 h. Associations are expressed in odds ratios with 95% confidence interval.
resultsIn the analysis of 19.563 cases, the overall incidence for an EMS re-contact within 72 h was 5.0% (N = 984/19.563), with 3.4% (669/19.563) within 24 h, 1.0% (195/19.563) within 24-48 h and 0.6% (120/19.563) within 48-72 h. In a subset of 13.010 complete cases, significant multivariable associations were observed between re-contacts and age > 65 (OR 2.15, CI 1.82-2.53), male gender (OR 1.39, CI 1.18-1.63), and medical complaints related to specialism 'Pulmonology' (OR 2.45, CI 1.67-3.64), 'Neurology' (OR 1.81, CI 1.28-2.59) and 'Traumatology/surgery' (OR 0.51, CI 0.34-0.76). Other significant associations were noted with night-time cases (OR 1.49, CI 1.21-1.82) and cases in which consultation or handover to a general practitioner occurred (OR 1.25, CI 1.06-1.47).
conclusionsA low overall incidence of EMS re-contacts indicates that non-conveyance within the EMS system is relatively safe. The likelihood of re-contact is higher for age above 65, male gender, and medical complaints within the specialisms of 'Pulmonology' and 'Neurology'. Non-conveyance cases that involve consultation or handover to a GP and cases occurring at night are also more likely to have a re-contact. The findings inform non-conveyance decision-making, and could serve as a starting point to adapt EMS curricula, and develop guidelines and protocols. This may fuel the enhancement of non-conveyance decision-making, thereby improving the quality of healthcare within the EMS system.
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